Universal Health Realty Income Trust (UHT) 10-K 27 Feb 24 2023 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Jan. 31, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2023
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Entity Registrant Name	UNIVERSAL HEALTH REALTY INCOME TRUST
Entity Central Index Key	0000798783
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Common Stock, Shares Outstanding		13,824,052
Entity Public Float			$ 609.4
Entity Current Reporting Status	Yes
Entity Shell Company	false
Entity File Number	1-9321
Entity Tax Identification Number	23-6858580
Entity Address, Address Line One	Universal Corporate Center
Entity Address, Address Line Two	367 South Gulph Road
Entity Address, Address Line Three	P.O. Box 61558
Entity Address, City or Town	King of Prussia
Entity Address, State or Province	PA
Entity Address, Postal Zip Code	19406-0958
City Area Code	610
Local Phone Number	265-0688
Entity Interactive Data Current	Yes
Entity Incorporation, State or Country Code	MD
Trading Symbol	UHT
Security Exchange Name	NYSE
Title of 12(b) Security	Shares of beneficial interest, $0.01 par value
Document Annual Report	true
Document Transition Report	false
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction	false
Auditor Name	KPMG LLP
Auditor Firm ID	185
Auditor Location	Philadelphia, Pennsylvania
Documents Incorporated by Reference	Portions of the registrant’s definitive proxy statement for our 2024 Annual Meeting of Shareholders, which will be filed with the Securities and Exchange Commission within 120 days after December 31, 2023 (incorporated by reference under Part III).

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2023		Dec. 31, 2022
Real Estate Investments:
Buildings and improvements and construction in progress	$ 649,374		$ 641,338
Accumulated depreciation	(262,449)	[1]	(248,772)
Real Estate Investment Property, Net, Total	386,925		392,566
Land	56,870		56,631
Net Real Estate Investments	443,795		449,197
Financing receivable from UHS	83,279		83,603
Net Real Estate Investments and Financing receivable	527,074		532,800
Investments in LLCs before amounts included in accrued expenses and other liabilities	9,102		9,282
Other Assets:
Cash and cash equivalents	8,212		7,614
Lease and other receivables from UHS	6,180		5,388
Lease receivable - other	8,166		8,445
Intangible assets (net of accumulated amortization of $12.5 million and $15.4 million, respectively)	9,110		9,447
Right-of-use land assets, net	10,946		11,457
Deferred charges and other assets, net	17,579		23,107
Total Assets	596,369		607,540
Liabilities:
Line of credit borrowings	326,600		298,100
Mortgage notes payable, non-recourse to us, net	32,863		44,725
Accrued interest	490		373
Accrued expenses and other liabilities	13,500		12,873
Ground lease liabilities, net	10,946		11,457
Tenant reserves, deposits and deferred and prepaid rents	11,036		10,911
Total Liabilities	395,435		378,439
Equity:
Preferred shares of beneficial interest, $.01 par value; 5,000,000 shares authorized; none issued and outstanding
Common shares, $.01 par value; 95,000,000 shares authorized; issued and outstanding: 2023 - 13,823,899; 2022 - 13,803,335	138		138
Capital in excess of par value	270,398		269,472
Cumulative net income and other	826,061		810,661
Cumulative dividends	(902,975)		(863,181)
Accumulated other comprehensive income	7,312		12,011
Total Equity	200,934		229,101
Total Liabilities and Equity	$ 596,369		$ 607,540
[1] The aggregate cost for federal income tax purposes is $ 710 million (unaudited) with a net book value of $ 422 million (unaudited).

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Intangible assets, accumulated amortization	$ 12.5	$ 15.4
Preferred shares of beneficial interest, par value	$ 0.01	$ 0.01
Preferred shares of beneficial interest, shares authorized	5,000,000	5,000,000
Preferred shares of beneficial interest, issued	0	0
Preferred shares of beneficial interest, outstanding	0	0
Common shares, par value	$ 0.01	$ 0.01
Common shares, shares authorized	95,000,000	95,000,000
Common shares, issued	13,823,899	13,803,335
Common shares, outstanding	13,823,899	13,803,335

CONSOLIDATED STATEMENTS OF INCO

CONSOLIDATED STATEMENTS OF INCOME - USD ($) shares in Thousands, $ in Thousands		12 Months Ended
		Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Revenues:
Revenues, Total		$ 95,575	$ 90,625	$ 84,190
Expenses:
Depreciation and amortization		27,733	26,557	27,478
Other operating expenses		31,170	28,305	23,441
Costs and Expenses, Total		64,226	59,959	55,325
Income before equity in income of unconsolidated limited liability companies ("LLCs"), loss on divestiture and interest expense		31,349	30,666	28,865
Equity in income of unconsolidated LLCs		1,207	1,191	1,796
(Loss)/gain on divestitures of real estate assets		(232)		87,314
Interest expense, net		(16,924)	(10,755)	(8,809)
Net income		$ 15,400	$ 21,102	$ 109,166
Basic earnings per share		$ 1.12	$ 1.53	$ 7.94
Diluted earnings per share		$ 1.11	$ 1.53	$ 7.92
Weighted average number of shares outstanding - Basic		13,786	13,771	13,757
Weighted average number of share equivalents		28	24	22
Weighted average number of shares and equivalents outstanding - Diluted		13,814	13,795	13,779
Management Service
Expenses:
Advisory fees to UHS		$ 5,323	$ 5,097	$ 4,406
UHS Facilities
Revenues:
Lease revenue	[1]	32,623	29,954	29,896
Interest income on financing leases - UHS facilities		5,458	5,474
UHS Facilities | Other
Revenues:
Other revenue		946	948	891
Non-Related Parties
Revenues:
Lease revenue		54,993	52,004	52,324
Non-Related Parties | Other
Revenues:
Other revenue		$ 1,555	$ 2,245	$ 1,079
[1] Includes bonus rental on McAllen Medical Center, a UHS acute care hospital facility, o f $ 2,953 and $ 2,801 for the years ended December 31, 2023 and December 31, 2022, respectively, and includes bonus rental on three UHS acute care hospital facilities of $ 6,906 for the year ended December 31, 2021 .

CONSOLIDATED STATEMENTS OF IN_2

CONSOLIDATED STATEMENTS OF INCOME (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
McAllen Medical Center | UHS Hospital Facilities
Bonus rental	$ 2,953	$ 2,801	$ 6,906

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Comprehensive Income [Abstract]
Net Income (Loss)	$ 15,400	$ 21,102	$ 109,166
Other comprehensive income/(loss):
Unrealized derivative (loss)/gain on cash flow hedges	(4,699)	10,898	4,928
Total other comprehensive (loss)/income:	(4,699)	10,898	4,928
Total comprehensive income	$ 10,701	$ 32,000	$ 114,094

CONSOLIDATED STATEMENTS OF CHAN

CONSOLIDATED STATEMENTS OF CHANGES IN EQUITY - USD ($) shares in Thousands, $ in Thousands	Total	Common stock	Capital in excess of par value	Cumulative net income	Cumulative dividends	Accumulated other comprehensive income/(loss)
Balance at Dec. 31, 2020	$ 159,005	$ 138	$ 267,368	$ 680,727	$ (785,413)	$ (3,815)
Balance, Shares at Dec. 31, 2020		13,771
Shares of Beneficial Interest:
Issued	216		216
Issued (in shares)		14
Repurchased	(16)		(16)
Restricted stock-based compensation expense	947		947
Dividends	(38,585)				(38,585)
Comprehensive income:
Net income	109,166			109,166
Net income/(loss) applicable to noncontrolling interest	(334)			(334)
Unrealized net gain on cash flow hedges	4,928					4,928
Subtotal - comprehensive income	113,760			108,832		4,928
Balance at Dec. 31, 2021	235,327	$ 138	268,515	789,559	(823,998)	1,113
Balance, Shares at Dec. 31, 2021		13,785
Shares of Beneficial Interest:
Issued	177		177
Issued (in shares)		18
Restricted stock-based compensation expense	780		780
Dividends	(39,183)				(39,183)
Comprehensive income:
Net income	21,102			21,102
Unrealized net gain on cash flow hedges	10,898					10,898
Subtotal - comprehensive income	32,000			21,102		10,898
Balance at Dec. 31, 2022	229,101	$ 138	269,472	810,661	(863,181)	12,011
Balance, Shares at Dec. 31, 2022		13,803
Shares of Beneficial Interest:
Issued	146		146
Issued (in shares)		21
Restricted stock-based compensation expense	780		780
Dividends	(39,794)				(39,794)
Comprehensive income:
Net income	15,400			15,400
Unrealized net gain on cash flow hedges	(4,699)					(4,699)
Subtotal - comprehensive income	10,701			15,400		(4,699)
Balance at Dec. 31, 2023	$ 200,934	$ 138	$ 270,398	$ 826,061	$ (902,975)	$ 7,312
Balance, Shares at Dec. 31, 2023		13,824

CONSOLIDATED STATEMENTS OF CH_2

CONSOLIDATED STATEMENTS OF CHANGES IN EQUITY (Parenthetical) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Stockholders' Equity [Abstract]
Dividend Per Share	$ 2.88	$ 2.84	$ 2.8

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash flows from operating activities:
Net income	$ 15,400	$ 21,102	$ 109,166
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	27,733	26,557	27,478
Amortization related to above/below market leases, net	(143)	(143)	(183)
Amortization of debt premium	(40)	(50)	(51)
Amortization of deferred financing costs	729	714	791
Stock-based compensation expense	780	780	947
Loss/(gain) on divestitures of real estate assets	232		(87,314)
Changes in assets and liabilities:
Lease receivables	(513)	(2,083)	(843)
Accrued expenses and other liabilities	(316)	1,105	90
Tenant reserves, deposits and deferred and prepaid rents	(516)	(79)	(1,130)
Accrued interest	117	27	(5)
Leasing costs paid	(1,768)	(1,927)	(1,378)
Other, net	1,244	802	157
Net cash provided by operating activities	42,939	46,805	47,725
Cash flows from investing activities:
Investments in LLCs	(4,058)	(94)	(16,750)
Cash distributions from LLCs	757	875	418
Advance received from/(made to) LLC, net	3,500		(3,500)
Additions to real estate investments, net	(15,583)	(22,485)	(14,120)
Deposit on real estate assets			(200)
Cash paid for acquisition of properties	(7,620)	(13,620)	(12,989)
Net cash paid as part of asset exchange transaction		(1,346)	(2,839)
Cash paid to acquire minority interest in majority-owned LP			(3,092)
Cash proceeds received from divestiture of properties, net	3,894		28,119
Increase in cash and cash equivalents due to recording of LP on a consolidated basis			528
Net cash used in investing activities	(19,110)	(36,670)	(24,425)
Cash flows from financing activities:
Net borrowings on line of credit	28,500	26,200	35,700
Repayments of mortgage notes payable	(11,891)	(12,199)	(2,079)
Financing costs paid	(222)	(26)	(1,842)
Dividends paid	(39,765)	(39,177)	(38,532)
Issuance of shares of beneficial interest, net	147	177	215
Net cash used in financing activities	(23,231)	(25,025)	(6,538)
Increase/(decrease) in cash and cash equivalents	598	(14,890)	16,762
Cash and cash equivalents, beginning of year	7,614	22,504	5,742
Cash and cash equivalents, end of year	8,212	7,614	22,504
Supplemental disclosures of cash flow information:
Interest paid	16,266	10,386	8,076
Invoices accrued for construction and improvements	$ 2,947	$ 1,664	$ 1,594

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Pay vs Performance Disclosure
Net Income (Loss)	$ 15,400	$ 21,102	$ 109,166

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Dec. 31, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Organization and Summary of Sig

Organization and Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Organization and Summary of Significant Accounting Policies	(1) ORGANIZATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Nature of Operations Universal Health Realty Income Trust and subsidiaries (the “Trust”) is organized as a Maryland real estate investment trust. We invest in healthcare and human-service related facilities currently including acute care hospitals, behavioral health care hospitals, specialty facilities, free-standing emergency departments, childcare centers and medical/office buildings. As of February 27, 2024, we have seventy-six real estate investments located in twenty-one states consisting of: • six hospital facilities consisting of three acute care hospitals and three behavioral health care hospitals; • four free-standing emergency departments (“FEDs”); • sixty medical/office buildings (“MOB s”), including four owned by unconsolidated limited liability companies (“LLCs”)/limited liability partnerships (“LPs”); • four preschool and childcare centers; • one specialty facility that is currently vacant, and; • one vacant land investment located in Chicago, Illinois. Many of the factors that could affect our future results are beyond our control or ability to predict. Future operations and financial results of our tenants, and in turn ours, could be materially impacted by numerous factors and future developments. Such factors and developments include, but are not limited to, the impact of changes in patient volumes and payer mix caused by deteriorating macroeconomic conditions (including increases in uninsured and underinsured patients as the result of business closings and layoffs); potential disruptions to clinical staffing and shortages and disruptions related to supplies required for our tenants’ employees and patients, including equipment, pharmaceuticals and medical supplies, potential increases to expenses incurred by our tenants related to staffing, supply chain or other expenditures; the impact of our indebtedness and the ability to refinance such indebtedness on acceptable terms; disruptions in the financial markets and the business of financial institutions which could impact our ability to access capital or increase associated borrowing costs; and changes in general economic conditions nationally and regionally in the markets our properties are located, including higher sustained rates of unemployment and underemployment levels and reduced consumer spending and confidence, and; and the impact of COVID-19. Certain factors may result in the inability or unwillingness on the part of some of our tenants to make timely payment of their rent to us at current levels or to seek to amend or terminate their leases which, in turn, would have an adverse effect on our occupancy levels and our revenue and cash flow and the value of our properties, and potentially, our ability to maintain our dividend at current levels. Decreases in cash flows and results of operations may have an impact on the inputs and assumptions used in significant accounting estimates, including potential impairments of intangible and long-lived assets. Our future results of operations could be unfavorably impacted by government regulations and deterioration in general economic conditions which could result in increases in the number of people unemployed and/or uninsured. Should that occur, it may result in decreased occupancy rates at our MOBs as well as a reduction in the revenues earned by the operators of our hospital facilities which would unfavorably impact our future bonus rental revenue (on one Universal Health Services, Inc. hospital facility) and may potentially have a negative impact on the future lease renewal terms and the underlying value of the hospital properties. Management is unable to predict the effect, if any, that these factors may have on the operating results of our lessees or on their ability to meet their obligations under the terms of their leases with us. Management’s estimate of future cash flows from our leased properties could be materially affected in the near term, if certain of the leases are not renewed or renewed with less favorable terms at the end of their lease terms. In addition, the increase in interest rates has substantially increased our costs of borrowing and reduced our ability to access the capital markets on favorable terms. Additional increases in interest rates could have a significant unfavorable impact on our future results of operations and the resulting effect on the capital markets could adversely affect our ability to carry out our strategy. Purchase Accounting for Acquisition of Investments in Real Estate Purchase accounting is applied to the assets and liabilities related to most real estate investments acquired from third parties. In accordance with current accounting guidance, we account for most of our property acquisitions as acquisitions of assets, which requires the capitalization of acquisition costs to the underlying assets and prohibits the recognition of goodwill or bargain purchase gains. The fair value of most of the real estate acquired is allocated to the acquired tangible assets, consisting primarily of land, building and tenant improvements, and identified intangible assets and liabilities, consisting of the value of above-market and below-market leases, and acquired ground leases, based in each case on their fair values. Loan premiums, in the case of above market rate assumed loans, or loan discounts, in the case of below market assumed loans, are recorded based on the fair value of any loans assumed in connection with acquiring the real estate. Please see additional disclosure below regarding “Financing Assets”. The fair values of the tangible assets of an acquired property are determined based on comparable land sales for land and replacement costs adjusted for physical and market obsolescence for the improvements. The fair values of the tangible assets of an acquired property are also determined by valuing the property as if it were vacant, and the “as-if-vacant” value is then allocated to land, building and tenant improvements based on management’s determination of the relative fair values of these assets. Management determines the as-if-vacant fair value of a property based on assumptions that a market participant would use, which is similar to methods used by independent appraisers. In addition, there is intangible value related to having tenants leasing space in the purchased property, which is referred to as in-place lease value. Such value results primarily from the buyer of a leased property avoiding the costs associated with leasing the property and also avoiding rent losses and unreimbursed operating expenses during the hypothetical lease-up period. Factors considered by management in performing these analyses include an estimate of carrying costs during the expected lease-up periods considering current market conditions and costs to execute similar leases. In estimating carrying costs, management includes real estate taxes, insurance and other operating expenses and estimates of lost rental revenue during the expected lease-up periods based on current market demand. Management also estimates costs to execute similar leases including leasing commissions, tenant improvements, legal and other related costs. The value of in-place leases is amortized to expense over the remaining initial terms of the respective leases. In allocating the fair value of the identified intangible assets and liabilities of an acquired property, above-market and below-market in-place lease values are recorded based on the present value (using an interest rate which reflects the risks associated with the leases acquired) of the difference between (i) the contractual amounts to be paid pursuant to the in-place leases and (ii) estimated fair market lease rates from the perspective of a market participant for the corresponding in-place leases, measured, for above-market leases, over a period equal to the remaining non-cancelable term of the lease and, for below-market leases, over a period equal to the initial term plus any below market fixed rate renewal periods. The capitalized above-market lease values are amortized as a reduction of rental income over the remaining non-cancelable terms of the respective leases. The capitalized below-market lease values, also referred to as acquired lease obligations, are amortized as an increase to rental income over the initial terms of the respective leases. At December 31, 2023, our net intangible asset s total $ 9.1 million (net of $ 12.5 million accumulated amortization) and primarily consist of the value of in-place leases. At December 31, 2023, our net intangible value of in-place leases total $ 7.7 million (net of $ 11.0 million of accumulated amortization) and will be amortized over the remaining lease terms (aggregate weighted average of 5.3 years at December 31, 2023) and are expected to result in estimated aggregate amortization expense of, $ 1.6 million, $ 1.5 million, $ 1.3 million, $ 1.0 million and $ 2.4 million for 2024, 2025, 2026, 2027 and 2028 and thereafter, respectively. Amortization expense on intangible values of in place leases was $ 1.9 million for the year ended December 31, 2023, $ 2.1 million for the year ended December 31, 2022 and $ 2.6 million for the year ended December 31, 2021. The remaining amount of our net intangible assets primarily consists of above-market leases. At December 31, 2023, our net intangible value of above-market leases total $ 1.2 million (net of $ 1.4 million of accumulated amortization) and will be amortized over the remaining lease terms (aggregate weighted average of approximately 5.6 years at December 31, 2023) and are expected to result in estimated aggregate amortization offset to rental revenue of approximately $ 215,000 in 2024, $ 215,000 in 2025, $ 209,000 in 2026, $ 197,000 in 2027 and $ 370,000 in 2028 and thereafter. Amortization offset to rental revenue on intangible values of above-market leases was $ 246,000 , $ 247,000 and $ 205,000 for the years ended December 31, 2023, 2022 and 2021, respectively. Depreciation is computed using the straight-line method over the estimated useful lives of the buildings and capital improvements. The estimated original useful lives of our buildings range from 25 - 45 years and the estimated original useful lives of capital improvements ranges from 3 - 35 years. On a consolidated basis, depreciation expense was $ 24.6 million for the year ended December 31, 2023, $ 23.3 million for the year ended December 31, 2022 and $ 23.9 million for the year ended December 31, 2021. Financing Assets As discussed in Note 2 – Relationship with UHS and Related Party Transactions, on December 31, 2021 we entered into an asset purchase and sale agreement, as amended, with UHS and certain of its affiliates. Pursuant to the agreement, UHS purchased from us the real estate assets of the Inland Valley Campus of Southwest Healthcare System (“Inland Valley”) and transferred to us the real estate assets of Aiken Regional Medical Center (“Aiken”) and Canyon Creek Behavioral Health (“Canyon Creek”). In connection with this transaction, Aiken and Canyon Creek (as lessees), entered into a master lease and individual property leases (with us as lessor), as amended, for initial lease terms of approximately twelve years , ending on December 31, 2033. As a result of UHS' purchase option within the lease agreements of Aiken and Canyon Creek, the transaction is accounted for as a failed sale leaseback in accordance with U.S. GAAP and the properties acquired by us in connection with the asset purchase and sale agreement with UHS, as amended, were accounted for as financing arrangements and our consolidated balance sheets as of December 31, 2023 and December 31, 2022 include financing receivables related to this transaction of $ 83.3 million and $ 83.6 million, respectively. As of December 31, 2023, there are no indicators of impairment and the financing receivable will be assessed for recoverability in accordance with our asset impairment policy. Cash and Cash Equivalents We consider all highly liquid investment instruments with original maturities of three months or less to be cash equivalents. Asset Impairment We review each of our properties for indicators that its carrying amount may not be recoverable. Examples of such indicators may include a significant decrease in the market price of the property, a change in the expected holding period for the property, a significant adverse change in how the property is being used or expected to be used based on the underwriting at the time of acquisition, an accumulation of costs significantly in excess of the amount originally expected for the acquisition or development of the property, or a history of operating or cash flow losses of the property. When such impairment indicators exist, we review an estimate of the future undiscounted net cash flows (excluding interest charges) expected to result from the real estate investment’s use and eventual disposition and compare that estimate to the carrying value of the property. We consider factors such as future operating income, trends and prospects, as well as the effects of leasing demand, competition and other factors. If our future undiscounted net cash flow evaluation indicates that we are unable to recover the carrying value of a real estate investment, an impairment loss is recorded to the extent that the carrying value exceeds the estimated fair value of the property. The evaluation of anticipated cash flows is highly subjective and is based in part on assumptions regarding future occupancy, rental rates and capital requirements that could differ materially from actual results in future periods. Since cash flows on properties considered to be long-lived assets to be held and used are considered on an undiscounted basis to determine whether the carrying value of a property is recoverable, our strategy of holding properties over the long-term directly decreases the likelihood of their carrying values not being recoverable and therefore requiring the recording of an impairment loss. If our strategy changes or market conditions otherwise dictate an earlier sale date, an impairment loss may be recognized and such loss could be material. If we determine that the asset fails the recoverability test, the affected assets must be reduced to their fair value. We generally estimate the fair value of rental properties utilizing a discounted cash flow analysis that includes projections of future revenues, expenses and capital improvement costs that a market participant would use based on the highest and best use of the asset, which is similar to the income approach that is commonly utilized by appraisers. In certain cases, we may supplement this analysis by obtaining outside broker opinions of value or third-party appraisals. In considering whether to classify a property as held for sale, we consider factors such as whether management has committed to a plan to sell the property, the property is available for immediate sale in its present condition for a price that is reasonable in relation to its current value, the sale of the property is probable, and actions required for management to complete the plan indicate that it is unlikely that any significant changes will made to the plan. If all the criteria are met, we classify the property as held for sale. Upon being classified as held for sale, depreciation and amortization related to the property ceases and it is recorded at the lower of its carrying amount or fair value less cost to sell. The assets and related liabilities of the property are classified separately on the consolidated balance sheets for the most recent reporting period. Only those assets held for sale that constitute a strategic shift or that will have a major effect on our operations are classified as discontinued operations. Investments in Limited Liability Companies (“LLCs”) In accordance with U.S. GAAP and guidance relating to accounting for investments and real estate ventures, we account for our unconsolidated investments in LLCs/LPs which we do not control using the equity method of accounting. The third-party members in these investments have equal voting rights with regards to issues such as, but not limited to: (i) divestiture of property; (ii) annual budget approval, and; (iii) financing commitments. These investments, which represent 33 % to 95 % non-controlling ownership interests, are recorded initially at our cost and subsequently adjusted for our net equity in the net income, cash contributions to, and distributions from, the investments. Pursuant to certain agreements, allocations of sales proceeds and profits and losses of some of the LLC investments may be allocated disproportionately as compared to ownership interests after specified preferred return rate thresholds have been satisfied. Distributions received from equity method investees in the consolidated statements of cash flows are classified based upon the nature of the distribution. Returns on investments are presented net of equity in income from unconsolidated investments as cash flows from operating activities. Returns of investments are classified as cash flows from investing activities. During the fourth quarter of 2021, we purchased the 5 % minority ownership interest, held by the third-party member in Grayson Properties, LP which owns the Texoma Medical Plaza, in which we previously held a noncontrolling majority ownership interest. As a result of this minority ownership purchase, we own 100 % of the LP and began to account for it on a consolidated basis effective November 1, 2021. Prior to November 1, 2021, the LP was accounted for on an unconsolidated basis pursuant to the equity method. The property’s assets and liabilities are recorded at the carrying amount of its previously held interest, plus the incremental cost which was allocated based upon relative fair values. A third-party appraisal was completed to determine the fair value of the property. There was no material impact on our net income as a result of the consolidation of this LP subsequent to the transaction. At December 31, 2023, we have non-controlling equity investments or commitments in four jointly-owned LLCs/LPs which own MOBs. As of December 31, 2023 we accounted for these LLCs/LPs on an unconsolidated basis pursuant to the equity method since they are not variable interest entities which we are the primary beneficiary nor do we have a controlling voting interest. The majority of these entities are joint-ventures between us and non-related parties that hold minority ownership interests in the entities. Each entity is generally self-sustained from a cash flow perspective and generates sufficient cash flow to meet its operating cash flow requirements and service the third-party debt (if applicable) that is non-recourse to us. Although there is typically no ongoing financial support required from us to these entities since they are cash-flow sufficient, we may, from time to time, provide funding for certain purposes such as, but not limited to, significant capital expenditures, leasehold improvements and debt financing. Although we are not obligated to do so, if approved by us at our sole discretion, additional cash funding is typically advanced as equity or member loans. These entities maintain property insurance on the properties. An other-than-temporary impairment of an investment in an unconsolidated LLC is recognized when the carrying value of the investment is not considered recoverable based on evaluation of the severity and duration of the decline in value, including projected declines in cash flow. To the extent impairment has occurred, the excess carrying value of the asset over its estimated fair value is charged to income. Federal Income Taxes No provision has been made for federal income tax purposes since we qualify as a real estate investment trust under Sections 856 to 860 of the Internal Revenue Code of 1986, and intend to continue to remain so qualified. To qualify as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute at least 90 % of our annual REIT taxable income to shareholders. As a REIT, we generally will not be subject to federal, state or local income tax on income that we distribute as dividends to our shareholders. We are subject to a federal excise tax computed on a calendar year basis. The excise tax equals 4 % of the amount by which 85% of our ordinary income plus 95% of any capital gain income for the calendar year exceeds cash distributions during the calendar year, as defined. No provision for excise tax has been reflected in the financial statements as no tax was due. Earnings and profits, which determine the taxability of dividends to shareholders, will differ from net income reported for financial reporting purposes due to the differences for federal tax purposes in the cost basis of assets and in the estimated useful lives used to compute depreciation and the recording of provision for impairment losses. The aggregate gross cost basis and net book value of the properties for federal income tax purposes are approximately $710 million (unaudited) and $ 422 million (unaudited), respectively, at December 31, 2023. The aggregate cost basis and net book value of the properties for federal income tax purposes were approximately $ 681 million (unaudited) and $ 406 million (unaudited), respectively, at December 31, 2022. Stock-Based Compensation We expense the grant-date fair value of restricted stock awards over the vesting period. We recognize the grant-date fair value of equity-based compensation and account for these transactions using the fair-value based method. The expense associated with share-based compensation arrangements is a non-cash charge. In the Consolidated Statements of Cash Flows, stock-based compensation expense is an adjustment to reconcile net income to cash provided by operating activities. Fair Value Fair value is a market-based measurement, not an entity-specific measurement and determined based upon the assumptions that market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, accounting requirements establish a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs that are classified within Level 1 and 2 of the hierarchy) and the reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy). In instances when it is necessary to establish the fair value of our real estate investments and investments in LLCs we use unobservable inputs which are typically based on our own assumptions. The fair value of our real estate investments, components of real estate investments and debt assumed in conjunction with acquisition and impairment activity, are considered to be Level 3 valuations as they are primarily based upon an income capitalization approach. Significant inputs into the models used to determine fair value of real estate investments and components of real estate investments include future cash flow projections, holding period, terminal capitalization rate and discount rates. Additionally, the fair value of land takes into consideration comparable sales, as adjusted for site specific factors. The fair value of real estate investments is based upon significant judgments made by management, and accordingly, we typically obtain assistance from third party valuation specialists. Significant inputs into the models used to determine the fair value of assumed mortgages included the outstanding balance, term, stated interest rate and current market rate of the mortgage. The carrying amounts reported in the balance sheet for cash, receivables, and short-term borrowings approximate their fair values due to the short-term nature of these instruments. Accordingly, these items are excluded from the fair value disclosures included elsewhere in these notes to the consolidated financial statements. Concentration of Revenues The rental revenue earned pursuant to the lease on McAllen Medical Center, which is leased to a related party (see Note 2), generated approximately 9 % during each of 2023 and 2022 and approximately 10 % during 2021, of our consolidated revenues. Use of Estimates The preparation of financial statements in conformity with generally accepted accounting principles in the United States of America requires us to make estimates and assumptions that affect the amounts reported in our consolidated financial statements and accompanying notes. Actual results could differ from those estimates. New Accounting Standards Except as noted below there were no new accounting pronouncements that impacted or are expected to impact us. Reference Rate Reform In March 2020, the FASB issued an accounting standard classified under FASB ASC Topic 848, “Reference Rate Reform.” The amendments in this update contain practical expedients for reference rate reform related activities that impact debt, leases, derivatives and other contracts. The guidance in ASC 848 is optional and may be elected over time as reference rate reform activities occur. Beginning in the first quarter of 2020, we elected to apply the hedge accounting expedients related to probability and the assessments of effectiveness for future LIBOR-indexed cash flows to assume that the index upon which future hedged transactions will be based matches the index on the corresponding derivatives. Application of these expedients preserves the presentation of derivatives consistent with past presentation. We will continue to evaluate the impact of the guidance and may apply other elections as applicable as additional changes in the market occur. In December 2022, the FASB issued ASU 2022-06, Deferral of the Sunset Date of Topic 848 (“ASU 2022-06”) which was issued to defer the sunset date of Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform to December 31, 2024. ASU 2022-06 is effective immediately for all companies. ASU 2022-06 had no impact on our condensed consolidated financial statements for the year ended December 31, 2023.

Relationship with UHS and Relat

Relationship with UHS and Related Party Transactions	12 Months Ended
	Dec. 31, 2023
Related Party Transactions [Abstract]
Relationship with UHS and Related Party Transactions	(2) RELATIONSHIP WITH UHS AND RELATED PARTY TRANSACTIONS Leases: We commenced operations in 1986 by purchasing certain properties from subsidiaries of UHS and immediately leasing the properties back to the respective subsidiaries. The base rentals and lease and renewal terms for each of the hospitals leased to subsidiaries of UHS as of January 1, 2024, are provided below. The base rents are paid monthly. The lease on McAllen Medical Center also provides for bonus rent which is paid quarterly based upon a computation that compares the hospital’s current quarter revenue to a corresponding quarter in the base year. The hospital leases with subsidiaries of UHS, with the exception of the lease on Clive Behavioral Health (which is operated by UHS in a joint venture with an unrelated third party), are unconditionally guaranteed by UHS and are cross-defaulted with one another. The lease for Clive Behavioral Health is guaranteed on a several basis by UHS ( 52 %) and Catholic Health Initiatives-Iowa ( 48 %). The combined revenues generated from the leases on the three acute care and three behavioral health care hospital facilities leased to subsidiaries of UHS at December 31, 2023 and 2022, accounted fo r approximately 25 % and 26 % of our consolidated revenues for the years ended December 31, 2023 and 2022, respectively. In addition to the six UHS hospital facilities, we have twenty-one properties consisting of medical/office buildings (including one newly constructed MOB that was substantially completed during the first quarter of 2023 and one MOB that was acquired during the third quarter of 2023), and FEDs that are either wholly or jointly-owned by us that include tenants that are subsidiaries of UHS. The aggregate revenues generated from UHS-related tenants comprised approximately 37 % of our consolidated revenue for the five years ended December 31, 2023 (approximately 41 %, 40 % and 37 % for the years ended December 31, 2023, 2022 and 2021, respectively). On December 31, 2021, we entered into an asset purchase and sale agreement with UHS and certain of its affiliates, which was amended during the first quarter of 2022, pursuant to the terms of which: • a wholly-owned subsidiary of UHS purchased from us, the real estate assets of the Inland Valley Campus of Southwest Healthcare System located in Wildomar, California, at its fair market value of $ 79.6 million. • two wholly-owned subsidiaries of UHS transferred to us, the real estate assets of the following properties: o Aiken Regional Medical Center, (“Aiken”), located in Aiken, South Carolina (which includes an acute care hospital and a behavioral health pavilion), at its fair-market value of approximately $ 57.7 million, and; o Canyon Creek Behavioral Health (“Canyon Creek”), located in Temple, Texas, at its fair-market value of approximately $ 26.0 million. • in connection with this transaction, since the fair-market value of Aiken and Canyon Creek, which totaled approximately $ 83.7 million in the aggregate, exceeded the $ 79.6 million fair-market value of the Inland Valley Campus of Southwest Healthcare System, we paid approximately $ 4.1 million in cash to UHS. This transaction generated a gain of approximately $ 68.4 million which is included in our consolidated statement of income for the year ended December 31, 2021. As a result of UHS’ purchase option within the lease agreements of Aiken and Canyon Creek, the transaction is accounted for as a failed sale leaseback in accordance with U.S. GAAP and the properties acquired by us in connection with the asset purchase and sale agreement with UHS, as amended, were accounted for as financing arrangements and our consolidated balance sheets as of December 31, 2023 and 2022 include financing receivables related to this transaction of $ 83.3 million and $ 83.6 million, respectively. Additionally, we structured the purchase and sale of the above-mentioned properties as a like-kind exchange of property under the provisions of Section 1031 of the Internal Revenue Code of 1986, as amended Also on December 31, 2021, Aiken and Canyon Creek (as lessees), entered into a master lease and individual property leases as amended, (with us as lessor), for initial lease terms on each property of approximately twelve years , ending on December 31, 2033 . Subject to the terms of the master lease, Aiken and Canyon Creek have the right to renew their leases, at the then current fair market rent (as defined in the master lease), for seven , five-year optional renewal terms. Pursuant to the leases, as amended during the first quarter of 2022, the aggregate annual rental rate on the acquired properties, which is payable to us on a monthly basis, was approximately $ 5.8 million during 2023 ($ 4.0 million related to Aiken and $ 1.8 million related to Canyon Creek) and $ 5.7 million during 2022 ($ 3.9 million related to Aiken and $ 1.8 million related to Canyon Creek). The portion of the lease payments that is included in our consolidated statements of income, and reflected as interest income on financing leases, was approximately $ 5.5 million for each of the years ended December 31, 2023 and 2022. There is no bonus rental component applicable to either of these leases. Lease revenue will not be impacted by the lease payments received related to these two properties. Pursuant to the terms of the lease on the Inland Valley Campus, we earned $ 4.5 million of lease revenue during the year ended December 31, 2021 (consisting of $ 2.6 million in base rental and $ 1.9 million in bonus rental). Pursuant to the terms of the master leases among us and certain subsidiaries of UHS, dated December 24, 1986 and December 31, 2021 (the “Master Leases”), which govern the leases of McAllen Medical Center, Wellington Regional Medical Center (governed by the Master Lease dated December 24, 1986), Aiken Regional Medical Center and Canyon Creek Behavioral Health (governed by the Master Lease dated December 31, 2021, as amended), all of which are hospital properties that are wholly-owned subsidiaries of UHS, UHS has the option, among other things, to renew the leases at the lease terms described below by providing notice to us at least 90 days prior to the termination of the then current term. UHS also has the right to purchase the respective leased facilities from us at their appraised fair market value upon any of the following: (i) at the end of the lease terms or any renewal terms; (ii) upon one month’s notice should a change of control of the Trust occur, or; (iii) within the time period as specified in the leases in the event that UHS provides notice to us of their intent to offer a substitution property/properties in exchange for one (or more) of the four wholly-owned UHS hospital facilities leased from us, should we be unable to reach an agreement with UHS on the properties to be substituted. Additionally, UHS has rights of first refusal to: (i) purchase the respective leased facilities during and for 180 days after the lease terms at the same price, terms and conditions of any third-party offer, or; (ii) renew the lease on the respective leased facility at the end of, and for 180 days after, the lease term at the same terms and conditions pursuant to any third-party offer. In addition, a wholly-owned subsidiary of UHS is the managing, majority member in a joint-venture with an unrelated third-party that operates, and leases from us, Clive Behavioral Health. This 100 -bed behavioral health care facility is located in Clive, Iowa, and was completed and opened in late December, 2020 and the hospital lease commenced on December 31, 2020. The lease on this facility is triple net and has an initial term of 20 years with five 10 -year renewal options . On each January 1 st through 2040 (and potentially through 2070 if the first three of five, 10-year renewal options are exercised), the annual rental will increase by 2.75 % on a cumulative and compounded basis. The first three of the five 10-year renewal options will provide for annual rental as stipulated in the lease (2041 through 2070) and the two additional 10 -year lease renewal options will be at fair market value lease rates ( 2071 through 2090 ). Pursuant to the lease on this facility, the joint venture has the option to, among other things, renew the lease at the terms specified in the lease agreement by providing notice to us at least 270 days prior to the termination of the then current term. The joint venture also has the right to purchase the leased facility from us at its appraised fair market value upon either of the following: (i) by providing notice at least 270 days prior to the end of the lease terms or any renewal terms, or; (ii) upon 30 days’ notice anytime within 12 months of a change of control of the Trust (UHS also has this right should the joint venture decline to exercise its purchase right). Additionally, the joint venture has rights of first offer to purchase the facility prior to any third-party sale. The table below details the existing lease terms and renewal options for each of the hospital leases that are related to UHS as of January 1, 2024, co nsisting of three acute care hospitals and three behavioral health hospitals: Hospital Name Annual End of Renewal McAllen Medical Center $ 5,485,000 December, 2026 5 (a) Wellington Regional Medical Center $ 6,639,000 December, 2026 5 (b) Aiken Regional Medical Center/Aurora Pavilion Behavioral Health Services $ 4,072,000 December, 2033 35 (c) Canyon Creek Behavioral Health $ 1,841,000 December, 2033 35 (c) Clive Behavioral Health $ 2,775,000 December, 2040 50 (d) (a) UHS has one 5-year renewal option at existing lease rates (through 2031 ). (b) UHS has one 5-year renewal option at fair market value lease rates (through 2031 ; see additional disclosure below). The annual rental will increase by 2.5 % on an annual compounded basis on each January 1 st through 2026. (c) UHS has seven 5-year renewal options at fair market value lease rates ( 2034 through 2068 ). The annual rental rate will increase by 2.25 % on a cumulative and compounded basis on each January 1 st through 2033 . (d) The UHS-related joint venture has five 10-year renewal options; the first three of the five 10-year renewal options will be at computed lease rates as stipulated in the lease ( 2041 through 2070 ) and the last two 10-year renewal options will be at fair market lease rates ( 2071 through 2090 ). On each January 1 st through 2040 (and potentially through 2070 if the first three of five, 10-year renewal options are exercised), the annual rental will increase by 2.75 % on a cumulative and compounded basis. Upon the December 31, 2021 expiration of the leas e on Wellington Regional Medical Center located in West Palm Beach, Florida, a wholly-owned subsidiary of UHS exercised its fair market value renewal option and renewed the lease for a 5 -year term scheduled to expire on December 31, 2026. Effective January 1, 2023, the annual fair market value lease rate for this hospital, which was payable to us monthly, was $ 6.5 million (there is no longer a bonus rental component of the lease payment). On January 1, 2024 the annual rent increased to $ 6.6 million and on each January 1 st thereafter through 2026, the annual rent will increase by 2.50 % on a cumulative and compounded basis. Pursuant to the terms of the hospital’s previous lease, we earned aggregate lease revenue of $ 5.5 million during the year ended December 31, 2021, (consisting of $ 3.0 million of base rental and $ 2.5 million of bonus rental). Management cannot predict whether the leases with wholly-owned subsidiaries of UHS, which have renewal options at existing lease rates or fair market value lease rates, or any of our other leases, will be renewed at the end of their lease term. If the leases are not renewed at their current rates or the fair market value lease rates, we would be required to find other operators for those facilities and/or enter into leases on terms potentially less favorable to us than the current leases. In addition, if subsidiaries of UHS exercise their options to purchase the respective leased hospital or FED facilities upon expiration of the lease terms, our future revenues could decrease if we were unable to earn a favorable rate of return on the sale proceeds received, as compared to the rental revenue currently earned pursuant to these leases. During the third quarter of 2023, we acquired the McAllen Doctor's Center, an MOB located in McAllen, Texas for a purchase price of approximately $ 7.6 million, including transaction costs. The building has approximately 79,500 rentable square feet and is 100 % master leased to McAllen Hospitals, L.P, a wholly-owned subsidiary of UHS. The triple-net master lease is for twelve years scheduled to expire on August 31, 2035 . McAllen Hospitals, L.P. has the option to renew the lease term for three consecutive ten-year terms. The initial annual base rent is approximately $ 624,000 . During the first quarter of 2023, construction was substantially completed on Sierra Medical Plaza I, a multi-tenant MOB located in Reno, Nevada, consisting of approximately 86,000 rentable square feet. This MOB is located on the campus of the Northern Nevada Sierra Medical Center, a newly constructed acute care hospital that is owned and operated by a wholly-owned subsidiary of UHS, which was completed and opened during April of 2022. The cost of the MOB is estimated to be approximately $ 35 million , approximately $ 29 million of which was incurred as of December 31, 2023. In connection with this MOB, we entered into a ground lease and master flex-lease agreement with a wholly-owned subsidiary of UHS. The master flex lease agreement has a ten-year term sched uled to expire on March 31, 2033, and covers approximately 68 % of the rentable square feet of the MOB at an initial minimum rent of $ 1.3 million annually plus a pro-rata share of the common area maintenance expenses. The master flex-lease is subject to a reduction during the term based upon the execution of third-party leases. The ground lease and the master flex lease each commenced during March, 2023. During the fourth quarter of 2021, we purchased the 5 % minority ownership interest held by a third-party member in Grayson Properties, LP which owns the Texoma Medical Plaza, an MOB located in Denison, Texas for approximately $ 3.1 million. The MOB is located on the campus of Texoma Medical Center, a hospital that is owned and operated by a wholly-owned subsidiary of UHS. A third-party appraisal was completed to determine the fair value of the property. As a result of this minority ownership purchase during the fourth quarter of 2021, we own 100 % of the LP and are therefore consolidating this LP effective with the purchase date. There was no material impact on our net income as a result of the consolidation of this LP subsequent to the transaction. Please see Note 8 for additional disclosure surrounding this transaction. In May, 2021, we acquired the Fire Mesa office building located in Las Vegas, Nevada for a purchase price of approximately $ 12.9 million. The building is 100 % leased under the terms of a triple net lease by a wholly-owned subsidiary of UHS. The initial lease is scheduled to expire on August 31, 2027 and has two five-year renewal options. As discussed in Note 4, the acquisition of this office building was part of a series of planned tax-deferred like-kind exchange transactions pursuant to Section 1031 of the Internal Revenue Code, as amended. We are the lessee on thirteen ground leases with subsidiaries of UHS (for consolidated and unconsolidated investments), including one that commenced in March, 2023. The remaining lease terms on the ground leases with subsidiaries of UHS range from approximately 26 years to approximately 75 years. The annual aggregate lease payments on these properties were approximately $ 571,000 for the year ended 2023 and expected to be $ 571,000 for each of the years ended 2024, 2025, 2026 and 2027, and an aggregate of $ 31.9 million thereafter. See Note 4 for further disclosure around our lease accounting. Officers and Employees: Our officers are all employees of a wholly-owned subsidiary of UHS and although as of December 31, 2023, we had no salaried employees, our officers do typically receive annual stock-based compensation awards in the form of restricted stock or restricted stock units. In special circumstances, if warranted and deemed appropriate by the Compensation Committee of the Board of Trustees, our officers may also receive one-time compensation awards in the form of restricted stock and/or cash bonuses. Advisory Agreement: UHS of Delaware, Inc. (the “Advisor”), a wholly-owned subsidiary of UHS, serves as Advisor to us under an advisory agreement dated December 24, 1986, and as amended and restated as of January 1, 2019 (the “Advisory Agreement”). Pursuant to the Advisory Agreement, the Advisor is obligated to present an investment program to us, to use its best efforts to obtain investments suitable for such program (although it is not obligated to present any particular investment opportunity to us), to provide administrative services to us and to conduct our day-to-day affairs. All transactions between us and UHS must be approved by the Trustees who are unaffiliated with UHS (the “Independent Trustees”). In performing its services under the Advisory Agreement, the Advisor may utilize independent professional services, including accounting, legal, tax and other services, for which the Advisor is reimbursed directly by us. The Advisory Agreement may be terminated for any reason upon sixty days written notice by us or the Advisor. The Advisory Agreement expires on December 31 of each year; however, it is renewable by us, subject to a determination by the Independent Trustees, that the Advisor’s performance has been satisfactory. The Advisory Agreement was renewed for 2024 with the same terms as the Advisory Agreement in place during 2023, 2022 and 2021. Our advisory fee for 2023, 2022 and 2021 was computed at 0.70 % of our average invested real estate assets, as derived from our consolidated balance sheet. Based upon a review of our advisory fee and other general and administrative expenses, as compared to an industry peer group, the advisory fee computation remained unchanged for 2023, as compared to 2022 and 2021. The average real estate assets for advisory fee calculation purposes exclude certain items from our consolidated balance sheet such as, among other things, accumulated depreciation, cash and cash equivalents, lease receivables, deferred charges and oth er assets. The advisory fee is payable quarterly, subject to adjustment at year-end based upon our audited financial statements. Advisory fees incurred and paid (or payable) to UHS amounted to $ 5.3 million during 2023, $ 5.1 million during 2022 and $ 4.4 million during 2021, and were based upon average invested real estate assets of $ 757 million, $ 728 million and $ 629 million during 2023, 2022 and 2021, respectively. Share Ownership: As of December 31, 2023 and 2022, UHS owned 5.7 % of our outstanding shares of beneficial interest. SEC reporting requirements of UHS: UHS is subject to the reporting requirements of the Securities and Exchange Commission (“SEC”) and is required to file annual reports containing audited financial information and quarterly reports containing unaudited financial information. Since the aggregate revenues generated from UHS-related tenants comprised approximately 37 % of our consolidated revenue for the five years ended December 31, 2023 (approximately 41 %, 40 % and 37 % for the years ended December 31, 2023, 2022 and 2021, respectively), and since a subsidiary of UHS is our Advisor, you are encouraged to obtain the publicly available filings for Universal Health Services, Inc. from the SEC’s website. Thes e filings are the sole responsibility of UHS and are not incorporated by reference herein.

Purchase and Sale Transaction,

Purchase and Sale Transaction, Acquisitions, Divestitures and New Construction	12 Months Ended
	Dec. 31, 2023
Business Combinations [Abstract]
Purchase and Sale Transaction, Acquisitions, Divestitures and New Construction	(3) PURCHA SE AND SALE TRANSACTION, ACQUISITIONS, DIVESTITURES AND NEW CONSTRUCTION 2023: New Construction: In January 2022, we entered into a ground lease and master flex-lease agreement with a wholly-owned subsidiary of UHS to develop, construct and own the real property of Sierra Medical Plaza I, an MOB located in Reno, Nevada, consisting of approximately 86,000 rentable square feet. This MOB is located on the campus of the Northern Nevada Sierra Medical Center, a newly constructed hospital that is owned and operated by a wholly-owned subsidiary of UHS, which was completed and opened during April of 2023. Please see additional disclosure in connection with this property in Note 2 . Acquisitions: During the third quarter of 2023, we acquired the McAllen Doctor's Center, an MOB located in McAllen, Texas, for a purchase price of approximately $ 7.6 million, including transaction costs. The building has approximately 79,500 rentable square feet and is 100 % master leased to McAllen Hospitals, L.P, a wholly-owned subsidiary of UHS. The triple-net master lease is for twelve years scheduled to expire on August 31, 2035 . McAllen Hospitals, L.P. has the option to renew the lease term for three consecutive ten-year terms. The initial annual base rent is approximately $ 624,000 . Divestitures: In December, 2023, we sold the vacant specialty facility in Corpus Christi, Texas for proceeds of approximately $ 3.9 million, net of closing costs. This divestiture generated a loss of approximately $ 232,000 which is included in our consolidated statements of income for the three and twelve month periods ended December 31, 2023. 2022: During 2022 and 2021, we completed various transactions as described and noted below utilizing qualified third-party intermediaries, as part of a series of anticipated tax-deferred like-kind exchange transactions pursuant to Section 1031 of the Internal Revenue Code, as amended. Acquisitions: In March, 2022, we acquired the Beaumont Heart and Vascular Center, a medical office building located in Dearborn, Michigan, for a purchase price of approximately $ 5.4 million. The building, which has 17,621 rentable square feet, is 100 % leased to a single tenant under the terms of a triple-net lease that is scheduled to expire on November 30, 2026 and has lease escalations of 2.5 % per year commencing on December 1, 2022. In January, 2022, we acquired the 140 Thomas Johnson Drive medical office building located in Frederick, Maryland, for a purchase price of approximately $ 8.0 million. The building, which has 20,146 rentable square feet, is 100 % leased to three tenants under the terms of triple-net leases. Approximately 72 % of the rentable square feet of this MOB is leased pursuant to a 15 -year lease, with a remaining lease term of approximately 14 years at the time of purchase, with three , five-year renewal options. Divestitures: There were no divestitures during 2022. 2021: Asset Purchase and Sale Agreement with UHS: On December 31, 2021, we entered into an asset purchase and sale agreement with UHS and certain of its affiliates, which was amended during the first quarter of 2022, pursuant to the terms of which: (i) a wholly-owned subsidiary of UHS purchased from us, the real estate assets of the Inland Valley Campus of Southwest Healthcare System located in Wildomar, California, at its fair market value of $ 79.6 million, and; (ii) two wholly-owned subsidiaries of UHS transferred to us, the real estate assets of Aiken Regional Medical Center located in Aiken, South Carolina (which includes an acute care hospital and a behavioral health pavilion), at its fair-market value of approximately $ 57.7 million, and Canyon Creek Behavioral Health located in Temple, Texas, at its fair-market value of approximately $ 26.0 million. In connection with this transaction, since the fair-market value of Aiken and Canyon Creek, which totaled approximately $ 83.7 million in the aggregate, exceeded the $ 79.6 million fair-market value of the Inland Valley Campus of Southwest Healthcare System, we paid approximately $ 4.1 million in cash to UHS. This transaction generated a gain of approximately $ 68.4 million which is included in our consolidated statement of income for the year ended December 31, 2021. Please see additional disclosure in connection with this transaction in Note 2. Acquisition: In May, 2021, as a part of the series of tax-deferred like-kind exchange transactions mentioned above, we acquired the Fire Mesa office building located in Las Vegas, Nevada for a purchase price of approximately $ 12.9 million. The building is 100 % leased under the terms of a triple net lease with a wholly-owned subsidiary of UHS. The lease on this building is scheduled to expire on August 31, 2027 and has two five-year renewal options. Divestitures: In November, 2021, as a part of the series of tax-deferred like-kind exchange transactions mentioned above, we sold the Auburn Medical Office Building II, a medical office building located in Auburn, Washington, for a sale price of approximately $ 24.9 million, net of closing costs. At December 31, 2021, approximately $ 15.2 million of cash related to the sale proceeds is held by the qualified third-party intermediary that we utilized for the series of anticipated tax-deferred like-kind exchange transactions, as mentioned above. This divestiture generated a gain of approximately $ 17.6 million which is included in our consolidated statement of income for the year ended December 31, 2021. In June, 2021, as a part of the series of tax-deferred like-kind exchange transactions mentioned above, we sold the Children’s Clinic at Springdale, a medical office building located in Springdale, Arkansas for a sale price of approximately $ 3.2 million, net of closing costs. This divestiture resulted in a gain of approximately $ 1.3 million which is included in our consolidated statement of income for the year ended December 31, 2021.

Lease Accounting

Lease Accounting	12 Months Ended
	Dec. 31, 2023
Leases [Abstract]
Lease Accounting	(4) LEASE ACCOUNTING As Lessor: We lease most of our operating properties to customers under agreements that are typically classified as operating leases (as noted below, two of our leases are accounted for as financing arrangements effective on December 31, 2021). We recognize the total minimum lease payments provided for under the operating leases on a straight-line basis over the lease term. Generally, under the terms of our leases, the majority of our rental expenses, including common area maintenance, real estate taxes and insurance, are recovered from our customers. We record amounts reimbursed by customers in the period that the applicable expenses are incurred, which is generally ratably throughout the term of the lease. We have elected the package of practical expedients that allows lessors to not separate lease and non-lease components by class of underlying asset. This practical expedient allowed us to not separate expenses reimbursed by our customers (“tenant reimbursements”) from the associated rental revenue if certain criteria were met. We assessed these criteria and concluded that the timing and pattern of transfer for rental revenue and the associated tenant reimbursements are the same, and for the leases that qualify as operating leases, we accounted for and presented rental revenue and tenant reimbursements as a single component under Lease revenue in our consolidated statements of income for the twelve months ended December 31, 2023, 2022 and 2021. The components of the “Lease revenue – UHS facilities” and “Lease revenue – Non-related parties” captions for the years ended 2023, 2022 and 2021 are disaggregated below (in thousands). Base rents are primarily stated rent amounts provided for under the leases that are recognized on a straight-line basis over the term of the lease. Bonus rents and tenant reimbursements represent amounts where tenants are contractually obligated to pay an amount that is variable in nature. Year Ended December 31, 2023 2022 2021 UHS Facilities: Base rents $ 26,173 $ 24,485 $ 21,498 Bonus rents (a.) 2,953 2,801 6,906 Tenant reimbursements 3,497 2,668 1,492 Lease Revenue - UHS facilities $ 32,623 $ 29,954 $ 29,896 Non-related parties: Base rents $ 42,159 $ 40,533 $ 41,880 Tenant reimbursements 12,834 11,471 10,444 Lease Revenue - Non-related parties $ 54,993 $ 52,004 $ 52,324 (a.) Includes bonus rental on McAllen Medical Center, a UHS acute care hospital facility of $ 2,953 and $ 2,801 for the years ended December 31, 2023 and 2022, respectively, and includes bonus rental on three UHS acute care hospital facilities of $ 6,906 for the year ended December 31, 2021. Please see disclosure below surrounding the December 31, 2021 asset purchase and sale transaction with UHS. Disclosures Related to Certain Hospital Facilities: Lease Renewal: Wellington Regional Medical Center: Upon the December 31, 2021 expiration of the lease on this acute care hospital located in West Palm Beach, Florida, a wholly-owned subsidiary of UHS exercised its fair market value renewal option and renewed the lease for a 5 -year term scheduled to expire on December 31, 2026. Effective January 1, 2022, the annual fair market value lease rate for this hospital, which is payable to us monthly, was $ 6.3 million (there is no longer a bonus rental component of the lease payment). On January 1, 2023 and 2024 the annual rent increased to $ 6.5 million and $ 6.6 million, respectively, and on each January 1 st thereafter through 2026, the annual rent will increase by 2.50 % on a cumulative and compounded basis. Pursuant to the hospital’s previous lease, we earned aggregate lease revenue of $ 5.5 million during the year ended December 31, 2021, (consisting of $ 3.0 million of base rental and $ 2.5 million of bonus rental). Asset Purchase and Sale Agreement: Southwest Healthcare System, Inland Valley Campus, Aiken Regional Medical Center and Canyon Creek Behavioral Health: On December 31, 2021, we entered into an asset purchase and sale agreement with UHS and certain of its affiliates, which was amended during the first quarter of 2022, pursuant to the terms of which: • a wholly-owned subsidiary of UHS purchased from us, the real estate assets of the Inland Valley Campus of Southwest Healthcare System located in Wildomar, California, at its fair market value of $ 79.6 million. • two wholly-owned subsidiaries of UHS transferred to us, the real estate assets of the following properties: o Aiken Regional Medical Center, (“Aiken”), located in Aiken, South Carolina (which includes an acute care hospital and a behavioral health pavilion), at its fair-market value of approximately $ 57.7 million, and; o Canyon Creek Behavioral Health (“Canyon Creek”), located in Temple, Texas, at its fair-market value of approximately $ 26.0 million. • in connection with this transaction, since the fair-market value of Aiken and Canyon Creek, which totaled approximately $ 83.7 million in the aggregate, exceeded the $ 79.6 million fair-market value of the Inland Valley Campus of Southwest Healthcare System, we paid approximately $ 4.1 million in cash to UHS. As we no longer have a controlling interest in Inland Valley Campus of Southwest Healthcare System, the transaction generated a gain of approximately $ 68.4 million which was included in our consolidated statement of income for the year ended December 31, 2021. As a result of UHS’ purchase option within the lease agreements of Aiken and Canyon Creek, the transaction is accounted for as a failed sale leaseback in accordance with U.S. GAAP and the properties acquired by us in connection with the asset purchase and sale agreement with UHS, as amended, were accounted for as financing arrangements and our consolidated balance sheets as of December 31, 2023 and 2022 include financing receivables related to this transaction of $ 83.3 million and $ 83.6 million, respectively. Additionally, we structured the purchase and sale of the above-mentioned properties as a like-kind exchange of property under the provisions of Section 1031 of the Internal Revenue Code of 1986, as amended. Also on December 31, 2021, Aiken and Canyon Creek (as lessees), entered into a master lease and individual property leases as amended, (with us as lessor), for initial lease terms on each property of approximately twelve years , ending on December 31, 2033 . Subject to the terms of the master lease, Aiken and Canyon Creek have the right to renew their leases, at the then current fair market rent (as defined in the master lease), for seven , five-year optional renewal terms. Pursuant to the leases, as amended during the first quarter of 2022, the aggregate annual rental rate on the acquired properties, which is payable to us on a monthly basis, was approximately $ 5.8 million during 2023 ($ 4.0 million related to Aiken and $ 1.8 million related to Canyon Creek) and $ 5.7 million during 2022 ($ 3.9 million related to Aiken and $ 1.8 million related to Canyon Creek). The portion of the lease payments that is included in our consolidated statements of income, and reflected as interest income on financing leases, was approximately $ 5.5 million for each of the years ended December 31, 2023 and 2022. There is no bonus rental component applicable to either of these leases. Lease revenue will not be impacted by the lease payments received related to these two properties. Pursuant to the terms of the lease on the Inland Valley Campus, we earned $ 4.5 million of lease revenue during the year ended December 31, 2021 (consisting of $ 2.6 million in base rental and $ 1.9 million in bonus rental). Vacant Specialty Facilities and Land: Corpus Christi, Texas - Facility: In December, 2023, we sold the vacant specialty facility in Corpus Christi, Texas, for proceeds of approximately $ 3.9 million, net of closing costs. This divestiture generated a loss of approximately $ 232,000 which is included in our consolidated statements of income for the year ended December 31, 2023. The lease on this specialty facility expired during 2019 and the facility had been vacant since that time. The operating expenses incurred by us in connection with this facility were approximately $ 254,000 during 2023, $ 302,000 during 2022 and $ 371,000 during 2021. Chicago, Illinois - Land: Demolition of the former specialty hospital located in Chicago, Illinois, was completed during 2023. Demolition costs, which were included in other operating expenses in our consolidated statements of income, amounted to approximately $ 1.5 million in the aggregate, approximately $ 1.1 million of which was incurred during 2023 and $ 332,000 of which was incurred during 2022. Including the demolition costs incurred, the operating expenses incurred by us in connection with this property were $ 1.7 million during 2023 (or $ 529,000 excluding the demolition costs) and $ 1.6 million during 20 22 (or approximately $ 1.3 million excluding demolition costs). Also, included in our net income during the year ended December 31, 2022, was $ 1.25 million of revenues related to a settlement and release agreement executed during the fourth quarter of 2022 in connection with this property. The lease on this facility expired on December 31, 2021. During 2021, we earned approximately $ 1.6 million of lease revenue in connection with this facility and the former tenant was responsible for the operating expenses. Evansville, Indiana - Facility: The lease on the specialty facility, located in Evansville, Indiana, expired during 2019 and the facility has been vacant since that time. The operating expenses incurred by us in connection with this facility were approximately $ 401,000 during 2023, $ 360,000 during 2022 and $ 366,000 during 2021. We continue to market the Chicago, Illinois, and Evansville, Indiana, properties to third parties. Future operating expenses related to these properties will be incurred by us during the time they remain owned and unleased. Should these properties continue to remain owned and unleased for an extended period of time, or should we incur substantial renovation or additional costs to make the properties suitable for other operators/tenants/buyers, our future results of operations could be materially unfavorably impacted. Minimum future base rents from non-cancelable leases related to properties included in our financial statements on a consolidated basis, excluding increases resulting from changes in the consumer price index, bonus rents and the impact of straight-line rent adjustments, are as follows (amounts in thousands): For the year ended December 31, Amount 2024 $ 76,221 2025 70,064 2026 63,358 2027 43,935 2028 36,586 Thereafter 151,894 Total minimum base rents $ 442,058 Some of the leases contain gross terms where operating expenses are included in the base rent amounts. Other leases contain net terms where the operating expenses are assessed separately from the base rentals. The table above contains a mixture of both gross and net leases and does not include any separately calculated operating expense reimbursements. Under the terms of the hospital leases, the lessees are required to pay all operating costs of the properties including property insurance and real estate taxes. Tenants of the medical office buildings generally are required to pay their pro-rata share of the property’s operating costs. As Lessee: We are the lessee with various third parties, including subsidiaries of UHS, in connection with ground leases for land at fifteen of our consolidated properties. Our right-of-use land assets represent our right to use the land for the lease term and our lease liabilities represent our obligation to make lease payments arising from the leases. Right-of-use assets and lease liabilities were recognized upon adoption of Topic 842 based on the present value of lease payments over the lease term. We utilized our estimated incremental borrowing rate, which was derived from information available as of January 1, 2019, or the commencement date of the ground lease, whichever is later, in determining the present value of lease payments for active leases on that date. A right-of-use asset and lease liability are not recognized for leases with an initial term of 12 months or less, as these short-term leases are accounted for similarly to previous guidance for operating leases. We do not currently have any ground leases with an initial term of 12 months or less . As of December 31, 2023, our condensed consolidated balance sheet includes right-of-use land assets, net, of approximately $ 10.9 million and ground lease liabilities, net, of approximately $ 10.9 million. During the first quarter of 2023, the ground lease for the newly constructed and substantially completed Sierra Medical Plaza I commenced and a right-of-use asset and lease liability was recorded in connection with t his lease. During the years end ed December 31, 2023 and 2022, the cash paid for amounts included in the measurement of lease liabilities related to our operating leases was approximately $ 666,000 and $ 611,000 , respectively, which is included as an operating cash outflow within the consolidated statement of cash flows and included in other operating expenses within the consolidated statements of income. As of and during the year ended December 31, 2023, we did not enter into any lease agreements for our consolidated properties set to commence in the future. As mentioned above, during 2023 there was a newly leased assets for which a right-of-use asset was recorded in exchan ge for a new lease liability, related to the Sierra Medical Plaza I. Supplemental balance sheet information related to leases was as follows (in thousands): December 31, 2023 Operating Leases Right-of-use land assets, net-operating leases $ 10,946 Ground lease liabilities, net $ 10,946 Weighted Average remaining lease term, years Operating leases 56.3 Weighted Average discount rate Operating leases 6.29 % As of December 31, 2023, we are the lessee with various third parties, including subsidiaries of UHS, in connection with ground leases for land at fifteen of our consolidated properties. Total consolidated amounts expensed relating to the applicable leases in 2023, 2022 and 2021 was approximately $ 666,000 , $ 611,000 and $ 508,000 , respectively. The following table summarizes fixed, future minimum rental payments, excluding variable costs, which are discounted by our incremental borrowing rate to calculate the lease liabilities for our operating leases in which we are the lessee. We do not include renewal options in the lease term for calculating the lease liability unless we are reasonably certain we will exercise the option. Maturities of lease liabilities are as follows (amounts in thousands): Year ended December 31: 2024 $ 704 2025 704 2026 704 2027 704 2028 704 Later years 36,027 Total undiscounted lease payments $ 39,547 Less imputed interest 28,601 Total $ 10,946

Debt and Financial Instruments

Debt and Financial Instruments	12 Months Ended
	Dec. 31, 2023
Debt Disclosure [Abstract]
Debt and Financial Instruments	1.50 x 3.1 x 4.3 x As indicated on the following table, we have various mortgages, all of which are non-recourse to us and are not cross-collateralized, included on our consolidated balance sheet as of December 31, 2023 and 2022 (amounts in thousands): As of 12/31/2023 As of 12/31/2022 Facility Name Interest Maturity Outstanding Outstanding Desert Valley Medical Center fixed rate mortgage loan (b.) 3.62 % January, 2023 $ - $ 4,194 2704 North Tenaya Way fixed rate mortgage loan (c.) 4.95 % November, 2023 - 6,252 Summerlin Hospital Medical Office Building III fixed 4.03 % April, 2024 12,301 12,558 Tuscan Professional Building fixed rate mortgage loan 5.56 % June, 2025 1,060 1,719 Phoenix Children’s East Valley Care Center fixed rate 3.95 % January, 2030 7,930 8,203 Rosenberg Children's Medical Plaza fixed rate mortgage loan 4.42 % September, 2033 11,771 12,027 Total, excluding net debt premium and net financing fees 33,062 44,953 Less net financing fees ( 199 ) ( 268 ) Plus net debt premium - 40 Total mortgage notes payable, non-recourse to us, net $ 32,863 $ 44,725 (a.) All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity. (b.) This $ 4.2 million fixed rate mortgage loan was fully repaid on January 3, 2023, utilizing borrowings under our Credit Agreement. (c.) This $ 6.3 million fixed rate mortgage loan was fully repaid on November 1, 2023, utilizing borrowings under our Credit Agreement. (d.) This loan is scheduled to mature within the next twelve months, at which time we will either refinance pursuant to a new mortgage loan or repay the mortgage balance in full utilizing borrowings under our Credit Agreement. The mortgages are secured by the real property of the buildings as well as property leases and rents. The mortgages outstanding as of December 31, 2023 had a combined carrying value of approximately $ 33.1 million and a combined fair value of approximately $ 31.2 million. At December 31, 2022, we had various mortgages, all of which were non-reco urse to us, included in our consolidated balance sheet. The combined outstanding balance of these various mortgages was $ 45.0 million and these mortgages had a combined fair value of approximately $ 43.2 million. The fair value of our debt was computed based upon quotes received from financial institutions. We consider these to be “level 2” in the fair value hierarchy as outlined in the authoritative guidance for disclosure in connection with debt instruments. Changes in market rates on our fixed rate debt impacts the fair value of debt, but it has no impact on interest incurred or cash flow. As of December 31, 2023, our aggregate consolidated scheduled debt repayments (including mortgages) are as follows (amounts in thousands): 2024 $ 13,550 2025 (a.) 327,539 2026 601 2027 626 2028 653 Later 16,693 Total $ 359,662 (a.) Includes assumed repayment of $ 326.6 million of outstanding borrowings under the terms of our $ 375 million revolving credit agreement scheduled to mature in July, 2025 . Financial Instruments: In December 2023, we entered into an interest rate swap agreement on a total notional amount of $ 25 million with a fixed interest rate of 3.9495 % that we designated as a cash flow hedge. The interest rate swap became effective on December 1, 2023 and is scheduled to mature on December 1, 2027 . If one-month term SOFR is above 3.9495 %, the counterparty pays us, and if one-month term SOFR is less than 3.9495 %, we pay the counterparty, the difference between the fixed rate of 3.9495 % and one-month term SOFR. In March 2020, we entered into an interest rate swap agreement on a total notional amount of $ 55 million with a fixed interest rate of 0.565 % that we designated as a cash flow hedge. The interest rate swap became effective on March 25, 2020 and is scheduled to mature on March 25, 2027 . On May 15, 2023, this interest rate swap agreement was modified to replace the benchmark rate from LIBOR to term SOFR. If one-month term SOFR is above 0.505 %, the counterparty pays us, and if one-month term SOFR is less than 0.505 %, we pay the counterparty, the difference between the fixed rate of 0.505 % and one-month term SOFR. In January 2020, we entered into an interest rate swap agreement on a total notional amount of $ 35 million with a fixed interest rate of 1.4975 % that we designated as a cash flow hedge. The interest rate swap became effective on January 15, 2020 and is scheduled to mature on September 16, 2024 . On May 15, 2023, this interest rate swap agreement was modified to replace the benchmark rate from LIBOR to term SOFR. If the one-month term SOFR is above 1.41 %, the counterparty pays us, and if the one-month term SOFR is less than 1.41 %, we pay the counterparty, the difference between the fixed rate of 1.41 % and one-month term SOFR. During the third quarter of 2019, we entered into an interest rate swap agreement on a total notional amount of $ 50 million with a fixed interest rate of 1.144 % that we designated as a cash flow hedge. The interest rate swap became effective on September 16, 2019 and is scheduled to mature on September 16, 2024 . On May 15, 2023, this interest rate swap agreement was modified to replace the benchmark rate from LIBOR to term SOFR. If one-month term SOFR is above 1.064 %, the counterparty pays us, and if one-month term SOFR is less than 1.064 %, we pay the counterparty, the difference between the fixed rate of 1.064 % and one-month term SOFR. We measure our interest rate swaps at fair value on a recurring basis. The fair value of our interest rate swaps is based on quotes from third parties. We consider those inputs to be “level 2” in the fair value hierarchy as outlined in the authoritative guidance for disclosures in connection with derivative instruments and hedging activities. At December 31, 2023, the fair value of our interest rate swaps was a net asset of $ 7.3 million which is included in deferred charges and other assets on the accompanying condensed consolidated balance sheet. During the twelve months of 2023, we received approximately $ 5.8 million from the counterparties (approximately $ 3.3 million of which relates to the two swaps that are scheduled to expire on September 16, 2024), adjusted for the previous quarter's accrual, pursuant to the terms of the swaps. During the twelve months of 2022, we paid or accrued approximately $ 414,000 to the counterparties by us, offset by approximately $ 1.4 million in receipts from the counterparties, adjusted for accruals, pursuant to the terms of the swaps. Cash flow hedges are accounted for by recording the fair value of the derivative instrument on the balance sheet as either an asset or a liability, with a corresponding amount recorded in accumulated other comprehensive income (“AOCI”) within shareholders’ equity. Amounts are reclassified from AOCI to the income statement in the period or periods the hedged transaction affects earnings. We do not expect any gains or losses on our interest rate swaps to be reclassified to earnings in the next twelve months. " id="sjs-B4" xml:space="preserve">(5) DEBT AND FINANCIAL INSTRUMENTS Debt: Management routinely monitors and analyzes the Trust’s capital structure in an effort to maintain the targeted balance among capital resources including the level of borrowings pursuant to our revolving credit facility, the level of borrowings pursuant to non-recourse mortgage debt secured by the real property of our properties and our level of equity including consideration of equity issuances. This ongoing analysis considers factors such as the current debt market and interest rate environment, the current/projected occupancy and financial performance of our properties, the current loan-to-value ratio of our properties, the Trust’s current stock price, the capital resources required for anticipated acquisitions and the expected capital to be generated by anticipated divestitures. This analysis, together with consideration of the Trust’s current balance of revolving credit agreement borrowings, non-recourse mortgage borrowings and equity, assists management in deciding which capital resource to utilize when events such as refinancing of specific debt components occur or additional funds are required to finance the Trust’s growth. On May 15, 2023 we entered into the first amendment to our amended and restated revolving credit agreement ("Credit Agreement") dated as of July 2, 2021 among the Trust as borrower, the lenders party thereto and Wells Fargo Bank, N.A., as administrative agent. The amendment replaced LIBOR with term SOFR plus .10 % ("adjusted term SOFR") as an alternative benchmark rate under the Credit Agreement for settings of benchmark rates that occur on or after the closing date in accordance with the benchmark replacement provisions set forth in the Credit Agreement. On July 2, 2021, we entered into an amended and restated Credit Agreement to amend and restate the previously existing $ 350 million credit agreement, as amended and dated June 5, 2020. Among other things, under the Credit Agreement, our aggregate revolving credit commitment was increased to $ 375 million from $ 350 million. The Credit Agreement, which is scheduled to mature on July 2, 2025 , provides for a revolving credit facility in an aggregate principal amount of $ 375 million, including a $ 40 million sublimit for letters of credit and a $ 30 million sublimit for swingline/short-term loans. Under the terms of the Credit Agreement, we may request that the revolving line of credit be increased by up to an additional $ 50 million. Borrowings under the new facility are guaranteed by certain subsidiaries of the Trust. In addition, borrowings under the new facility are secured by first priority security interests in and liens on all equity interests in most of the Trust’s wholly-owned subsidiaries. B orrowings under the Credit Agreement will bear interest at a rate equal to, at our option, at adjusted term SOFR for either one, three, or six months or the Base Rate, plus in either case, a specified margin depending on our total leverage ratio, as determined by the formula set forth in the Credit Agreement. The applicable margin after the first amendment ranges from 1.10 % to 1.35 % for adjusted term SOFR loans and 0. 10 % to 0.35 % for Base Rate loans . The Credit Agreement, as amended by the first amendment, defines “Base Rate” as the greatest of (a) the Administrative Agent’s prime rate, (b) the federal funds effective rate plus 1/2 of 1% and (c) one month adjusted term SOFR plus 1 %. The Trust will also pay a quarterly revolving facility fee ranging from 0.15 % to 0.35 % (depending on the Trust’s total leverage ratio) on the committed amount of the Credit Agreement. The Credit Agreement also provides for options to extend the maturity date and borrowing availability for two additional six-month periods. The margins over adjusted term SOFR, Base Rate and the facility fee are based upon our total leverage ratio. At December 31, 2023, the applicable margin over the adjusted term SOFR rate was 1.20 %, the margin over the Base Rate was 0.20 % and the facility fee was 0.20 %. At December 31, 2023, we had $ 326.6 million of outstanding borrowings and $ 3.1 million of letters of credit outstanding under our Credit Agreement. We had $ 45.3 million of available borrowing capacity, net of the outstanding borrowings and letters of credit outstanding as of December 31, 2023. The carrying amount and fair value of borrowings outstanding pursuant to the Credit Agreement was $ 326.6 million at December 31, 2023. There are no compensating balance requirements. The average amount outstanding under our Credit Agreement during the years ended December 31, 2023, 2022 and 2021 was $ 309.3 million, $ 277.9 million and $ 253.5 million, respectively, with corresponding effective interest rates of 4.8 %, 2.9 % and 2.2 %,respectively, including commitment fees and interest rate swaps/caps. At December 31, 2022, we had $ 298.1 million of outstanding borrowings outstanding against our revolving credit agreement that was in effect at that time, $ 3.1 million of letters of credit outstanding against the agreement and $ 73.8 million of available borrowing capacity. In our consolidated statements of cash flows, we report cash flows pursuant to our Credit Agreement on a net basis. Aggregate borrowings under our Credit Agreement were $ 78.4 million, $ 67.0 million and $ 88.8 million during the years ended December 31, 2023, 2022 and 2021, respectively, and aggregate repayments were $ 49.9 million, $ 40.8 million and $ 53.1 million durin g the years ended December 31, 2023, 2022 and 2021, respectively. The Credit Agreement contains customary affirmative and negative covenants, including limitations on certain indebtedness, liens, acquisitions and other investments, fundamental changes, asset dispositions and dividends and other distributions. The Credit Agreement also contains restrictive covenants regarding the Trust’s ratio of total debt to total assets, the fixed charge coverage ratio, the ratio of total secured debt to total asset value, the ratio of total unsecured debt to total unencumbered asset value, and minimum tangible net worth, as well as customary events of default, the occurrence of which may trigger an acceleration of amounts then outstanding under the Credit Agreement. We are in compliance with all of the covenants in the Credit Agreement at December 31, 2023, and were in compliance with all of the covenants of the Credit Agreement at December 31, 2022. We also believe that we would remain in compliance if, based on the assumption that the majority of the potential new borrowings will be used to fund investments, the full amount of our commitment was borrowed. The following table includes a summary of the required compliance ratios at December 31, 2023 and 2022, giving effect to the covenants contained in the Credit Agreements in effect on the respective dates (dollar amounts in thousands): Covenant December 31, 2023 December 31, 2022 Tangible net worth $ 125,000 $ 191,824 $ 219,654 Total leverage < 60 % 44.5 % 42.9 % Secured leverage < 30 % 4.1 % 5.6 % Unencumbered leverage < 60 % 44.2 % 41.8 % Fixed charge coverage > 1.50 x 3.1 x 4.3 x As indicated on the following table, we have various mortgages, all of which are non-recourse to us and are not cross-collateralized, included on our consolidated balance sheet as of December 31, 2023 and 2022 (amounts in thousands): As of 12/31/2023 As of 12/31/2022 Facility Name Interest Maturity Outstanding Outstanding Desert Valley Medical Center fixed rate mortgage loan (b.) 3.62 % January, 2023 $ - $ 4,194 2704 North Tenaya Way fixed rate mortgage loan (c.) 4.95 % November, 2023 - 6,252 Summerlin Hospital Medical Office Building III fixed 4.03 % April, 2024 12,301 12,558 Tuscan Professional Building fixed rate mortgage loan 5.56 % June, 2025 1,060 1,719 Phoenix Children’s East Valley Care Center fixed rate 3.95 % January, 2030 7,930 8,203 Rosenberg Children's Medical Plaza fixed rate mortgage loan 4.42 % September, 2033 11,771 12,027 Total, excluding net debt premium and net financing fees 33,062 44,953 Less net financing fees ( 199 ) ( 268 ) Plus net debt premium - 40 Total mortgage notes payable, non-recourse to us, net $ 32,863 $ 44,725 (a.) All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity. (b.) This $ 4.2 million fixed rate mortgage loan was fully repaid on January 3, 2023, utilizing borrowings under our Credit Agreement. (c.) This $ 6.3 million fixed rate mortgage loan was fully repaid on November 1, 2023, utilizing borrowings under our Credit Agreement. (d.) This loan is scheduled to mature within the next twelve months, at which time we will either refinance pursuant to a new mortgage loan or repay the mortgage balance in full utilizing borrowings under our Credit Agreement. The mortgages are secured by the real property of the buildings as well as property leases and rents. The mortgages outstanding as of December 31, 2023 had a combined carrying value of approximately $ 33.1 million and a combined fair value of approximately $ 31.2 million. At December 31, 2022, we had various mortgages, all of which were non-reco urse to us, included in our consolidated balance sheet. The combined outstanding balance of these various mortgages was $ 45.0 million and these mortgages had a combined fair value of approximately $ 43.2 million. The fair value of our debt was computed based upon quotes received from financial institutions. We consider these to be “level 2” in the fair value hierarchy as outlined in the authoritative guidance for disclosure in connection with debt instruments. Changes in market rates on our fixed rate debt impacts the fair value of debt, but it has no impact on interest incurred or cash flow. As of December 31, 2023, our aggregate consolidated scheduled debt repayments (including mortgages) are as follows (amounts in thousands): 2024 $ 13,550 2025 (a.) 327,539 2026 601 2027 626 2028 653 Later 16,693 Total $ 359,662 (a.) Includes assumed repayment of $ 326.6 million of outstanding borrowings under the terms of our $ 375 million revolving credit agreement scheduled to mature in July, 2025 . Financial Instruments: In December 2023, we entered into an interest rate swap agreement on a total notional amount of $ 25 million with a fixed interest rate of 3.9495 % that we designated as a cash flow hedge. The interest rate swap became effective on December 1, 2023 and is scheduled to mature on December 1, 2027 . If one-month term SOFR is above 3.9495 %, the counterparty pays us, and if one-month term SOFR is less than 3.9495 %, we pay the counterparty, the difference between the fixed rate of 3.9495 % and one-month term SOFR. In March 2020, we entered into an interest rate swap agreement on a total notional amount of $ 55 million with a fixed interest rate of 0.565 % that we designated as a cash flow hedge. The interest rate swap became effective on March 25, 2020 and is scheduled to mature on March 25, 2027 . On May 15, 2023, this interest rate swap agreement was modified to replace the benchmark rate from LIBOR to term SOFR. If one-month term SOFR is above 0.505 %, the counterparty pays us, and if one-month term SOFR is less than 0.505 %, we pay the counterparty, the difference between the fixed rate of 0.505 % and one-month term SOFR. In January 2020, we entered into an interest rate swap agreement on a total notional amount of $ 35 million with a fixed interest rate of 1.4975 % that we designated as a cash flow hedge. The interest rate swap became effective on January 15, 2020 and is scheduled to mature on September 16, 2024 . On May 15, 2023, this interest rate swap agreement was modified to replace the benchmark rate from LIBOR to term SOFR. If the one-month term SOFR is above 1.41 %, the counterparty pays us, and if the one-month term SOFR is less than 1.41 %, we pay the counterparty, the difference between the fixed rate of 1.41 % and one-month term SOFR. During the third quarter of 2019, we entered into an interest rate swap agreement on a total notional amount of $ 50 million with a fixed interest rate of 1.144 % that we designated as a cash flow hedge. The interest rate swap became effective on September 16, 2019 and is scheduled to mature on September 16, 2024 . On May 15, 2023, this interest rate swap agreement was modified to replace the benchmark rate from LIBOR to term SOFR. If one-month term SOFR is above 1.064 %, the counterparty pays us, and if one-month term SOFR is less than 1.064 %, we pay the counterparty, the difference between the fixed rate of 1.064 % and one-month term SOFR. We measure our interest rate swaps at fair value on a recurring basis. The fair value of our interest rate swaps is based on quotes from third parties. We consider those inputs to be “level 2” in the fair value hierarchy as outlined in the authoritative guidance for disclosures in connection with derivative instruments and hedging activities. At December 31, 2023, the fair value of our interest rate swaps was a net asset of $ 7.3 million which is included in deferred charges and other assets on the accompanying condensed consolidated balance sheet. During the twelve months of 2023, we received approximately $ 5.8 million from the counterparties (approximately $ 3.3 million of which relates to the two swaps that are scheduled to expire on September 16, 2024), adjusted for the previous quarter's accrual, pursuant to the terms of the swaps. During the twelve months of 2022, we paid or accrued approximately $ 414,000 to the counterparties by us, offset by approximately $ 1.4 million in receipts from the counterparties, adjusted for accruals, pursuant to the terms of the swaps. Cash flow hedges are accounted for by recording the fair value of the derivative instrument on the balance sheet as either an asset or a liability, with a corresponding amount recorded in accumulated other comprehensive income (“AOCI”) within shareholders’ equity. Amounts are reclassified from AOCI to the income statement in the period or periods the hedged transaction affects earnings. We do not expect any gains or losses on our interest rate swaps to be reclassified to earnings in the next twelve months.

Dividends and Equity Issuance P

Dividends and Equity Issuance Program	12 Months Ended
	Dec. 31, 2023
Equity [Abstract]
Dividends and Equity Issuance Program	(6) DIVIDENDS AND EQUITY ISSUANCE PROGRAM Dividends: During each of the last three years, dividends were declared and paid by us as follows: • 2023: $ 2.88 per share of which $ 1.73 per share was ordinary income and $ 1.15 per share was non-dividend distributions (there was no capital gain and no Unrecaptured Section 1250 gain in 2023). • 2022: $ 2.84 per share of which $ 2.24 per share was ordinary income and $ .60 per share was non-dividend distributions (there was no capital gain and no Unrecaptured Section 1250 gain in 2022). 2021: $ 2.80 per share of which $ 2.51 per share was ordinary income, $ .16 per share was non-dividend distributions and $ .13 per share was total capital gain (total capital gain amount includes Unrecaptured Section 1250 gain of $ .04 per share).

Incentive Plans

Incentive Plans	12 Months Ended
	Dec. 31, 2023
Postemployment Benefits [Abstract]
Incentive Plans	(7) INCENTIVE PLANS During 2007, our Board of Trustees and shareholders approved the Universal Health Realty Income Trust 2007 Restricted Stock Plan which was amended and restated in 2020 and 2016 (the “2007 Plan”). An aggregate of 175,000 shares (as amended in 2020) were authorized for issuance under this plan and a total of 159,373 shares, net of cancellations, have been issued pursuant to the terms of this plan, 127,205 of which have vested as of December 31, 2023. At December 31, 2023 there are 15,627 shares remaining for issuance under the terms of the 2007 Plan. During 2023, there were 17,104 restricted Shares of Beneficial Interest, net of cancellations, issued to the Trustees, officers and other personnel of the Trust pursuant to the 2007 Plan at a weighted average grant price of $ 48.48 per share (approximately $ 829,000 in the aggregate). These restricted shares are scheduled to vest in June of 2025 , (the second anniversary date of the grant date). Pursuant to the restricted shares issued during 2023, dividends on unvested stock will be deferred and accumulated prior to the vesting of the shares and paid, in either cash and/or stock, in the aggregate on the vesting date on the shares that ultimately vest. During 2022, there were 15,064 restricted Shares of Beneficial Interest, net of cancellations, issued to the Trustees, officers and other personnel of the Trust pursuant to the 2007 Plan at a weighted average grant price of $ 52.30 per share (approximately $ 788,000 in the aggregate). The majority of these restricted shares are scheduled to vest in June of 2024 , and additional shares are scheduled to vest in September and November, 2024 (the second anniversary date of each grant date). Pursuant to the restricted shares issued during 2022, dividends on unvested stock will be deferred and accumulated prior to the vesting of the shares and paid, in either cash and/or stock, in the aggregate on the vesting date on the shares that ultimately vest. During 2021, there were 10,165 restricted Shares of Beneficial Interest, net of cancellations, issued to the Trustees, officers and other personnel of the Trust pursuant to the 2007 Plan at a weighted average grant price of $ 71.69 per share ($ 729,000 in the aggregate, net of cancellations). These restricted shares vested in June of 2023 (the second anniversary date of the grant). Pursuant to the restricted shares issued during 2021, dividends on unvested stock were deferred and accumulated prior to the vesting of the shares and paid in cash in the aggregate upon the vesting of the shares. We expense the grant-date fair value restricted stock awards under the straight-line method over the stated vesting period of the award. In connection with these grants, we recorded compensation expense of approximately $ 780,000 in each of 2023 and 2022 and $ 947,000 during 2021. The remaining expense associated with these grants is approxim ately $ 762,000 and will be recorded over the remaining weighted average vesting period for outstanding restricted Shares of Beneficial Interest of approximately 1.2 years at December 31, 2023.

Summarized Financial Informatio

Summarized Financial Information of Equity Affiliates	12 Months Ended
	Dec. 31, 2023
Equity Method Investments and Joint Ventures [Abstract]
Summarized Financial Information of Equity Affiliates	(8) SUMMARIZED FINANCIAL INFORMATION OF EQUITY AFFILIATES In accordance with U. S. GAAP and guidance relating to accounting for investments and real estate ventures, we account for our unconsolidated investments in LLCs/LPs which we do not control using the equity method of accounting. The third-party members in these investments have equal voting rights with regards to issues such as, but not limited to: (i) divestiture of property; (ii) annual budget approval, and; (iii) financing commitments. These investments, which represent 33 % to 95 % non-controlling ownership interests, are recorded initially at our cost and subsequently adjusted for our net equity in the net income, cash contributions to, and distributions from, the investments. Pursuant to certain agreements, allocations of sales proceeds and profits and losses of some of the LLC investments may be allocated disproportionately as compared to ownership interests after specified preferred return rate thresholds have been satisfied. Distributions received from equity method investees in the consolidated statements of cash flows are classified based on the nature of the distribution. Returns on investments are presented net of equity in income from unconsolidated investments as cash flows from operating activities. Returns of investment are classified as cash flows from investing activities. At December 31, 2023, we have non-controlling equity investments or commitments in four jointly-owned LLCs/LPs which own MOBs. As of December 31, 2023, we accounted for these LLCs/LPs on an unconsolidated basis pursuant to the equity method since they are not variable interest entities which we are the primary beneficiary nor do we have a controlling voting interest. The majority of these entities are joint-ventures between us and non-related parties that hold minority ownership interests in the entities. Each entity is generally self-sustained from a cash flow perspective and generates sufficient cash flow to meet its operating cash flow requirements and service the third-party debt (if applicable) that is non-recourse to us. Although there is typically no ongoing financial support required from us to these entities since they are cash-flow sufficient, we may, from time to time, provide funding for certain purposes such as, but not limited to, significant capital expenditures, leasehold improvements and debt financing. Although we are not obligated to do so, if approved by us at our sole discretion, additional cash funding is typically advanced as equity or member loans. These entities maintain property insurance on the properties. During the fourth quarter of 2021, we purchased the 5 % minority ownership interest, held by the third-party member in Grayson Properties LP which owns the Texoma Medical Plaza, in which we previously held a noncontrolling majority ownership interest. As a result of this minority ownership purchase, we now own 100 % of the LP and began to account for it on a consolidated basis effective November 1, 2021. Prior to November 1, 2021, the LP was accounted for on an unconsolidated basis pursuant to the equity method. The following property table represents the four LLCs or LPs in which we own a non-controlling interest and were accounted for under the equity method as of December 31, 2023: Name of LLC/LP Ownership Property Owned by LLC/LP Suburban Properties 33 % St. Matthews Medical Plaza II Brunswick Associates (a.)(b.) 74 % Mid Coast Hospital MOB FTX MOB Phase II (c.) 95 % Forney Medical Plaza II Grayson Properties II (d.)(e.) 95 % Texoma Medical Plaza II (a.) This LLC has a third-party term loan of $ 8.5 million, which is non-recourse to us, outstanding as of December 31, 2023. (b.) We are the lessee with a third party on a ground lease for land. (c.) During the first quarter of 2021, this LP paid off its $ 4.7 million mortgage loan, upon maturity, utilizing pro rata equity contributions from the limited partners as well as a $ 3.5 million member loan from us to the LP which was funded utilizing borr owings from our revolving credit agreement. During the first quarter of 2023, the LP repaid $ 175,000 of the member loan and the remaining $ 3.3 million member loan balance was converted to an equity investment in the LP. (d.) This LP constructed, owns and operates the Texoma Medical Plaza II, on which construction substantially completed in December 2020. The MOB is located in Denison, Texas, on the campus of a hospital owned and operated by a wholly-owned subsidiary of UHS. We have committed to invest up to $ 5.2 million in eq uity and debt financing, $ 2.2 million of which has been funded as of December 31, 2023. This LP entered into a third-party construction loan commitment, which is non-recourse to us, which has an outstanding balance of $ 12.8 million as of December 31, 2023. Monthly principal and interest payments on this loan commenced on January 1, 2023. During the first quarter of 2024, $ 5.7 million of the third-party construction loan was repa id utilizing pro rata equity contributions from the partners. The third-party partner's share of the pro rata equity contributions was partially funded with a six-month, $ 128,000 partner loan from us. Our share of the pro rata equity contributions, as well as the third-party partner loan, were funded utilizing borrowings from our revolving credit agreement. As a result of the repayment of a portion of the construction loan, an associated $ 3.1 million letter of credit was terminated. (e.) We are the lessee with a UHS-related party for the land related to this property. Below are the combined statements of income for the four LLCs/LPs accounted for under the equity method at December 31, 2023, 2022 and 2021. The data for the year ended December 31, 2021 includes financial results for the above-mentioned Texoma Medical Plaza in which we purchased the minority ownership interest during the fourth quarter of 2021, for the period of January through October of 2021 only (during which it was accounted for under the equity method). For the Year Ended December 31, 2023 2022 2021 (amounts in thousands) Revenues $ 8,505 $ 8,204 $ 10,575 Operating expenses 3,351 3,177 4,093 Depreciation and amortization 1,873 1,853 2,198 Interest, net 825 1,061 1,721 Net income $ 2,456 $ 2,113 $ 2,563 Our share of net income $ 1,207 $ 1,191 $ 1,796 Below are the combined balance sheets for the four LLCs/LPs that were accounted for under the equity method as of December 31, 2023 and 2022: December 31, 2023 2022 (amounts in thousands) Net property, including construction in progress $ 28,488 $ 29,573 Other assets (a.) 4,667 4,334 Total assets $ 33,155 $ 33,907 Other liabilities (a.) $ 2,074 $ 2,338 Mortgage notes payable, non-recourse to us 21,206 21,802 Advances payable to us (b.) — 3,500 Equity 9,875 6,267 Total liabilities and equity $ 33,155 $ 33,907 Investments in LLCs before amounts included in accrued expenses and other liabilities 9,102 9,282 Amounts included in accrued expenses and other liabilities ( 1,729 ) ( 1,709 ) Our share of equity in LLCs, net $ 7,373 $ 7,573 (a.) Other assets and other liabilities as of December 31, 2023 and 2022, include approximately $ 651,000 and $ 654,000 , respectively, of right-of-use land assets and right-of-use land liabilities related to ground leases whereby the LLC/LP is the lessee, with third parties, including subsidiaries of UHS. (b.) This 7.25% member loan to FTX MOB Phase II, LP had a maturity date of March 1, 2023 . Upon the maturity date, the LP repaid $ 175,000 of the member loan to us and the remaining balance of $ 3.3 million was converted to an equity contribution by us. As of December 31, 2023, aggregate principal amounts due on mortgage notes payable by unconsolidated LLCs, which are accounted for under the equity method and are non-recourse to us, are as follows (amounts in thousands): 2024 $ 613 2025 12,704 2026 293 2027 301 2028 310 2029 and thereafter 6,985 Total $ 21,206 Mortgage Loan Balance (a.) Name of LLC/LP 12/31/2023 12/31/2022 Maturity Date Brunswick Associates (2.80% fixed rate mortgage loan) $ 8,453 $ 8,727 December, 2030 Grayson Properties II (3.70% fixed rate construction loan) (b.) 12,753 13,075 June, 2025 $ 21,206 $ 21,802 (a.) All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity. (b.) This construction loan required interest on the outstanding principal balance to be paid on a monthly basis through December 1, 2022. On January 1, 2023, monthly principal and interest payments on the loan commenced. During the first quarter of 2024, $ 5.7 million of the third-party construction loan was repa id utilizing pro rata equity contributions from the partners, as discussed above. As a result of the repayment of a portion of the construction loan, an associated $ 3.1 million letter of credit was terminated. Pursuant to the operating and/or partnership agreements of the four LLCs/LPs in which we continue to hold non-controlling ownership interests, the third-party member and the Trust, at any time, potentially subject to certain conditions, have the right to make an offer (“Offering Member”) to the other member(s) (“Non-Offering Member”) in which it either agrees to: (i) sell the entire ownership interest of the Offering Member to the Non-Offering Member (“Offer to Sell”) at a price as determined by the Offering Member (“Transfer Price”), or; (ii) purchase the entire ownership interest of the Non-Offering Member (“Offer to Purchase”) at the equivalent proportionate Transfer Price. The Non-Offering Member has 60 to 90 days to either: (i) purchase the entire ownership interest of the Offering Member at the Transfer Price, or; (ii) sell its entire ownership interest to the Offering Member at the equivalent proportionate Transfer Price. The closing of the transfer must occur within 60 to 90 days of the acceptance by the Non-Offering Member.

Segment Reporting

Segment Reporting	12 Months Ended
	Dec. 31, 2023
Segment Reporting [Abstract]
Segment Reporting	(9) SEGMENT REPORTING Our primary business is investing in and leasing healthcare and human service facilities through direct ownership or through joint ventures, which aggregate into a single reportable segment. We actively manage our portfolio of healthcare and human service facilities and may from time to time make decisions to sell lower performing properties not meeting our long-term investment objectives. The proceeds of sales are typically reinvested in new developments or acquisitions, which we believe will meet our planned rate of return. It is our intent that all healthcare and human service facilities will be owned or developed for investment purposes. Our revenue and net income are generated from the operation of our investment portfolio. Our portfolio is located throughout the United States, however, we do not distinguish or group our operations on a geographical basis for purposes of allocating resources or measuring performance. We review operating and financial data for each property on an individual basis; therefore, we define an operating segment as our individual properties. Individual properties have been aggregated into one reportable segment based upon their similarities with regard to both the nature and economics of the facilities, tenants and operational processes, as well as long-term average financial performance. No individual property meets the requirements necessary to be considered its own reportable segment.

Real Estate and Accumulated Dep

Real Estate and Accumulated Depreciation	12 Months Ended
	Dec. 31, 2023
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
Real Estate and Accumulated Depreciation	S chedule III Universal Health Realty Income Trust Real Estate and Accumulated Depreciation — December 31, 2023 (amounts in thousands) Gross amount at Date of which carried Completion of Initial Cost at end of period Accumulated Construction, Description Encumbrance Land Building Adjustments Land Building & CIP Total Depreciation Acquisition Date Average McAllen Medical Center McAllen, Texas — $ 4,720 $ 31,442 $ 10,189 $ 6,281 $ 40,070 $ 46,351 $ 32,892 1994 1986 42 Years Wellington Regional West Palm Beach, Florida — 1,190 14,652 17,370 1,663 31,549 33,212 24,410 2006 1986 42 Years Evansville Facility Evansville, Indiana — 500 6,945 1,062 500 8,007 8,507 6,897 1993 1989 40 Years 4058 W. Melrose Facility Central Chicago, Illinois — 158 6,404 ( 6,404 ) 158 — 158 — 1993 1986 25 Years Family Doctor’s Medical Shreveport, Louisiana — 54 1,526 549 54 2,075 2,129 1,350 1991 1995 45 Years Professional Buildings at Kingwood, Texas (d.) — 439 1,837 ( 297 ) 439 1,540 1,979 682 1995 1995 45 Years Chesterbrook Academy Audubon, Pennsylvania — 307 996 — 307 996 1,303 609 1996 1996 45 Years Chesterbrook Academy New Britain, Pennsylvania — 250 744 — 250 744 994 463 1991 1996 45 Years Chesterbrook Academy Uwchlan, Pennsylvania — 180 815 — 180 815 995 496 1992 1996 45 Years Chesterbrook Academy Newtown, Pennsylvania — 195 749 — 195 749 944 464 1992 1996 45 Years The Southern Crescent — 1,130 5,092 ( 1,991 ) 1,130 3,101 13 4,244 2,871 1994 1996 45 Years Southern Crescent Riverdale, Georgia — — — 5,389 806 4,583 13 5,402 3,665 2000 1998 35 Years Cypresswood Spring, Texas (e.) — 573 3,842 ( 2,122 ) 573 1,720 2,293 530 1997 1997 35 Years 701 South Tonopah Building Las Vegas, Nevada (f.) — — 1,579 68 — 1,647 1,647 1,600 1999 1999 25 Years Danbury Medical Plaza Danbury, Connecticut — 1,151 5,176 1,576 1,151 6,752 7,903 4,979 2000 2000 30 Years Corpus Christi Facility Corpus Christi, Texas — 1,104 5,508 ( 6,612 ) — — — — 2008 2008 35 Years Apache Junction Medical Plaza — 240 3,590 1,414 240 5,004 5 5,249 2,896 2004 2004 30 Years BRB Medical Office — 430 8,970 1,404 430 10,374 10,804 3,766 2010 2010 37 Years Centennial Hills Medical — — 19,890 3,606 — 23,496 226 23,722 10,191 2006 2006 34 Years Desert Springs Medical Plaza — 1,200 9,560 2,782 1,200 12,342 13,542 6,127 1998 1998 30 Years 700 Shadow Lane & — 400 11,300 5,766 400 17,066 889 18,355 8,549 2003 2003 30 Years Spring Valley Hospital MOB I — — 9,500 2,441 — 11,941 79 12,020 5,136 2004 2004 35 Years Spring Valley Hospital — — 9,800 2,162 — 11,962 289 12,251 5,009 2006 2006 34 Years Summerlin Hospital — 460 15,440 2,226 460 17,666 1,530 19,656 8,498 1999 1999 30 Years Schedule III Universal Health Realty Income Trust Real Estate and Accumulated Depreciation — December 31, 2023(continued) (amounts in thousands) Gross amount at Date of which carried Completion of Initial Cost at end of period Accumulated Construction, Description Encumbrance Land Building Adjustments Land Building & CIP Total Depreciation Acquisition Date Average Summerlin Hospital — 370 16,830 2,844 370 19,674 864 20,908 8,833 2000 2000 30 Years Summerlin Hospital 12,301 — 14,900 3,500 — 18,400 22 18,422 6,761 2009 2009 36 Years Emory at Dunwoody Dunwoody, GA — 782 3,455 — 782 3,455 4,237 1,528 2011 2011 35 Years Forney Medical Plaza Forney, TX — 910 11,960 1,126 910 13,086 13,996 5,368 2011 2011 35 Years Lake Pointe Medical Arts Rowlett, TX — 1,100 9,000 1,058 1,100 10,058 11,158 3,950 2011 2011 35 Years Tuscan Professional Building Irving, TX 1,060 1,100 12,525 3,301 1,100 15,826 9 16,935 6,611 2011 2011 35 Years PeaceHealth Medical Bellingham, WA — 1,900 24,910 921 1,900 25,831 27,731 9,905 2012 2012 35 Years Northwest Texas Amarillo, TX (f.) — — 7,180 1,526 — 8,706 8,706 3,157 2012 2012 35 Years Ward Eagle Office Village Farmington Hills, MI — 220 3,220 200 220 3,420 3,640 1,260 2013 2013 35 Years 5004 Poole Road MOB Denison, TX — 96 529 — 96 529 625 185 2013 2013 35 Years Desert Valley Medical — 2,280 4,624 1,408 2,280 6,032 11 8,323 2,593 1996 1996 30 Years Hanover Emergency Center Mechanicsville, VA — 1,300 6,224 — 1,300 6,224 7,524 1,953 2014 2014 35 Years Haas Medical Office Park Ottumwa, IA (g.) — — 3,571 — — 3,571 3,571 1,064 2015 2015 35 Years South Texas ER at Mission Mission, TX — 1,441 4,696 — 1,441 4,696 6,137 1,404 2015 2015 35 Years 3811 E. Bell — 930 6,929 2,397 930 9,326 263 10,519 3,969 2010 2010 30 Years The Northwest Medical Center Bentonville, AR — 1,100 2,870 140 1,100 3,010 4,110 979 2014 2014 35 Years Rosenberg Children’s 11,771 — 23,302 158 — 23,460 23,460 7,453 2001 2001 35 Years Phoenix Children’s East 7,930 1,050 10,900 — 1,050 10,900 11,950 3,446 2006 2006 35 Years Palmdale Medical Plaza — — 10,555 1,846 — 12,401 836 13,237 4,430 2008 2008 34 Years Piedmont-Roswell Physician Center Sandy Springs, GA — 2,338 2,128 — 2,338 2,128 4,466 798 2015 2015 30 Years Piedmont-Vinings Physician Center Vinings, GA — 1,348 2,418 — 1,348 2,418 3,766 876 2015 2015 30 Years Santa Fe Professional — 1,090 1,960 672 1,090 2,632 3,722 1,166 1999 1999 30 Years Sierra San Antonio Medical — — 11,538 876 — 12,414 336 12,750 4,867 2006 2006 30 Years Vista Medical Terrace & — — 9,276 2,533 — 11,809 123 11,932 5,056 2008 2008 30 Years South Texas ER at Weslaco Weslaco ,TX — 1,749 4,879 — 1,749 4,879 6,628 1,468 2015 2015 35 Years Chandler Corporate Center III Chandler, AZ — 2,328 14,131 — 2,328 14,131 16,459 5,176 2016 2016 35 Years Frederick Crestwood MOB Frederick, MD — 2,265 18,731 — 2,265 18,731 20,996 5,281 2016 2016 35 Years Madison Professional Madison, AL — 2,296 6,411 133 2,296 6,544 8,840 1,987 2016 2016 35 Years 2704 North Tenaya Way MOB Las Vegas, NV — 3,032 10,602 — 3,032 10,602 13,634 2,850 2016 2016 35 Years Henderson Medical Plaza Henderson, NV (f.) — — 10,718 10,500 — 21,218 54 21,272 8,538 2017 2017 35 Years Health Center at Hamburg Hamburg, PA — 696 3,406 — 696 3,406 4,102 886 2017 2017 35 Years Las Palmas Del Sol Emergency Center - West TX — 801 5,029 — 801 5,029 5,830 1,180 2017 2017 35 Years Beaumont Medical Sleep Center Building — 254 2,968 — 254 2,968 3,222 667 2018 2018 35 Years Clive Behavioral Health — 1,330 — 33,954 1,330 33,954 35,284 4,258 2020 2019 35 Years Gross amount at Date of which carried Completion of Initial Cost at end of period Accumulated Construction, Description Encumbrance Land Building Adjustments Land Building & CIP Total Depreciation Acquisition Date Average Bellin Health Family Medicine Center — 605 3,906 0 605 3,906 4,511 651 2019 2019 35 Years Sand Point Medical Properties — 265 1,654 — 265 1,654 1,919 203 2020 2020 35 Years Fire Mesa, LLC 2,400 9,671 2,400 9,671 12,071 1,209 2021 2021 35 Years Texoma Medical Plaza — — 19,771 214 — 19,985 19,985 6,764 2021 2021 39 Years Sierra Medical Plaza I — — 24,370 28 — 24,398 4,022 28,420 771 2023 2021 35 Years Beaumont Heart & Vascular Center — 537 4,434 537 4,434 4,971 356 2022 2022 35 Years 140 Thomas Johnson Drive — 1,197 5,635 1,197 5,635 6,832 414 2022 2022 35 Years McAllen Doctor's Center — 1,343 4,440 1,343 4,440 5,783 98 2023 2023 35 Years TOTALS (j.) $ 33,062 $ 55,134 $ 531,613 $ 109,913 $ 56,870 $ 639,790 $ 9,584 $ 706,244 $ 262,449 a. Consists of costs subsequent to acquisition that were capitalized, divested or written down in connection with asset impairments and hurricane related damage. b. During 2008, a $ 4.6 million provision for asset impairment was recorded in connection with the real estate assets of Southern Crescent Center I & Southern Crescent Center II. c. Consists of outstanding balances as of December 31, 2023 on third-party debt that is non-recourse to us. d. Carrying value of depreciable assets were written down to zero as a result of substantial damage from Hurricane Harvey during the third quarter of 2017. e. Carrying value of depreciable assets were written down as a result of substantial damage from Hurricane Harvey during the third quarter of 2017. f. We are the lessee with a UHS-related party on a ground lease for land. g. We are the lessee with a third party on a ground lease for land. h. We purchased the 5 % minority interest held by a third party during the fourth quarter of 2021. As a result of the minority interest purchase, we own 100 % of the LP. i. New construction project related to a new MOB located in Reno, Nevada, which was substantially completed in March, 2023 and is located on the campus of a UHS wholly- owned hospital that was completed and opened in April, 2022. j. The aggregate cost for federal income tax purposes is $ 710 million (unaudited) with a net book value of $ 422 million (unaudited). In addition to the real estate properties listed in the table above, as part of the December 31, 2021 asset purchase and sale agreement with UHS, as amended and as discussed herein, a wholly-owned subsidiary of UHS purchased the real estate assets of the Inland Valley Campus of Southwest Healthcare System from us, and transferred the real estate assets of two wholly-owned subsidiaries of UHS (Aiken Regional Medical Center and Canyon Creek Behavioral Health). The real estate assets received from UHS are recorded as a financing receivable from UHS on our Consolidated Balance Sheet at December 31, 2023. Please see Note 2 for additional disclosure. UNIVERSAL HEALTH REALTY INCOME TRUST NOTES TO SC HEDULE III DECEMBER 31, 2023 (amounts in thousands) (1) RECONCILIATION OF REAL ESTATE PROPERTIES The following table reconciles the Real Estate Properties from January 1, 2021 to December 31, 2023: 2023 2022 2021 Balance at January 1, $ 697,969 $ 663,733 $ 660,449 Impact of consolidation of an LP (a.) - - 19,771 Additions (b.) 17,505 22,555 11,346 Acquisitions 5,783 11,802 12,071 Disposals/Divestitures (c.) ( 15,013 ) ( 121 ) ( 39,904 ) Balance at December 31, $ 706,244 $ 697,969 $ 663,733 (2) RECONCILIATION OF ACCUMULATED DEPRECIATION The following table reconciles the Accumulated Depreciation from January 1, 2021 to December 31, 2023: 2023 2022 2021 Balance at January 1, $ 248,772 $ 225,584 $ 216,648 Impact of consolidation of an LP (a.) - - 4,847 Disposals/Divestitures (c.) ( 10,882 ) ( 121 ) ( 19,796 ) Depreciation expense 24,559 23,309 23,885 Balance at December 31, $ 262,449 $ 248,772 $ 225,584 (a) During the fourth quarter of 2021, we purchased the 5 % minority ownership interest held by a third-party member in an LP in which we previously held a non-controlling majority ownership interest. As a result of this minority interest purchase, we now own 100 % of the LP and the financial results are included in our consolidated financial statements. (b) Included in the additions for 2023, 2022 and 2021 are approximately $ 7.5 million, $ 18.0 million an d $ 2.9 million related to the construction of a new MOB , which was substantially completed in March, 2023, and is located on the campus of a UHS wholly-owned hospital that was completed and opened in April, 2022. (c) The 2023 year includes the sale of the Corpus Christi facility, as well as the demolition of the building previously located on the now-vacant land in Chicago, Illinois. The 2021 year includes the sale of the Auburn Medical Office Building II, the sale of the Children’s Clinic at Springdale as well as the exchange of Inland Valley Campus of Southwest Healthcare System, located in Wildomar, CA.

Organization and Summary of S_2

Organization and Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Nature of Operations	Nature of Operations Universal Health Realty Income Trust and subsidiaries (the “Trust”) is organized as a Maryland real estate investment trust. We invest in healthcare and human-service related facilities currently including acute care hospitals, behavioral health care hospitals, specialty facilities, free-standing emergency departments, childcare centers and medical/office buildings. As of February 27, 2024, we have seventy-six real estate investments located in twenty-one states consisting of: • six hospital facilities consisting of three acute care hospitals and three behavioral health care hospitals; • four free-standing emergency departments (“FEDs”); • sixty medical/office buildings (“MOB s”), including four owned by unconsolidated limited liability companies (“LLCs”)/limited liability partnerships (“LPs”); • four preschool and childcare centers; • one specialty facility that is currently vacant, and; • one vacant land investment located in Chicago, Illinois. Many of the factors that could affect our future results are beyond our control or ability to predict. Future operations and financial results of our tenants, and in turn ours, could be materially impacted by numerous factors and future developments. Such factors and developments include, but are not limited to, the impact of changes in patient volumes and payer mix caused by deteriorating macroeconomic conditions (including increases in uninsured and underinsured patients as the result of business closings and layoffs); potential disruptions to clinical staffing and shortages and disruptions related to supplies required for our tenants’ employees and patients, including equipment, pharmaceuticals and medical supplies, potential increases to expenses incurred by our tenants related to staffing, supply chain or other expenditures; the impact of our indebtedness and the ability to refinance such indebtedness on acceptable terms; disruptions in the financial markets and the business of financial institutions which could impact our ability to access capital or increase associated borrowing costs; and changes in general economic conditions nationally and regionally in the markets our properties are located, including higher sustained rates of unemployment and underemployment levels and reduced consumer spending and confidence, and; and the impact of COVID-19. Certain factors may result in the inability or unwillingness on the part of some of our tenants to make timely payment of their rent to us at current levels or to seek to amend or terminate their leases which, in turn, would have an adverse effect on our occupancy levels and our revenue and cash flow and the value of our properties, and potentially, our ability to maintain our dividend at current levels. Decreases in cash flows and results of operations may have an impact on the inputs and assumptions used in significant accounting estimates, including potential impairments of intangible and long-lived assets. Our future results of operations could be unfavorably impacted by government regulations and deterioration in general economic conditions which could result in increases in the number of people unemployed and/or uninsured. Should that occur, it may result in decreased occupancy rates at our MOBs as well as a reduction in the revenues earned by the operators of our hospital facilities which would unfavorably impact our future bonus rental revenue (on one Universal Health Services, Inc. hospital facility) and may potentially have a negative impact on the future lease renewal terms and the underlying value of the hospital properties. Management is unable to predict the effect, if any, that these factors may have on the operating results of our lessees or on their ability to meet their obligations under the terms of their leases with us. Management’s estimate of future cash flows from our leased properties could be materially affected in the near term, if certain of the leases are not renewed or renewed with less favorable terms at the end of their lease terms. In addition, the increase in interest rates has substantially increased our costs of borrowing and reduced our ability to access the capital markets on favorable terms. Additional increases in interest rates could have a significant unfavorable impact on our future results of operations and the resulting effect on the capital markets could adversely affect our ability to carry out our strategy.
Purchase Accounting for Acquisition of Investments in Real Estate	Purchase Accounting for Acquisition of Investments in Real Estate Purchase accounting is applied to the assets and liabilities related to most real estate investments acquired from third parties. In accordance with current accounting guidance, we account for most of our property acquisitions as acquisitions of assets, which requires the capitalization of acquisition costs to the underlying assets and prohibits the recognition of goodwill or bargain purchase gains. The fair value of most of the real estate acquired is allocated to the acquired tangible assets, consisting primarily of land, building and tenant improvements, and identified intangible assets and liabilities, consisting of the value of above-market and below-market leases, and acquired ground leases, based in each case on their fair values. Loan premiums, in the case of above market rate assumed loans, or loan discounts, in the case of below market assumed loans, are recorded based on the fair value of any loans assumed in connection with acquiring the real estate. Please see additional disclosure below regarding “Financing Assets”. The fair values of the tangible assets of an acquired property are determined based on comparable land sales for land and replacement costs adjusted for physical and market obsolescence for the improvements. The fair values of the tangible assets of an acquired property are also determined by valuing the property as if it were vacant, and the “as-if-vacant” value is then allocated to land, building and tenant improvements based on management’s determination of the relative fair values of these assets. Management determines the as-if-vacant fair value of a property based on assumptions that a market participant would use, which is similar to methods used by independent appraisers. In addition, there is intangible value related to having tenants leasing space in the purchased property, which is referred to as in-place lease value. Such value results primarily from the buyer of a leased property avoiding the costs associated with leasing the property and also avoiding rent losses and unreimbursed operating expenses during the hypothetical lease-up period. Factors considered by management in performing these analyses include an estimate of carrying costs during the expected lease-up periods considering current market conditions and costs to execute similar leases. In estimating carrying costs, management includes real estate taxes, insurance and other operating expenses and estimates of lost rental revenue during the expected lease-up periods based on current market demand. Management also estimates costs to execute similar leases including leasing commissions, tenant improvements, legal and other related costs. The value of in-place leases is amortized to expense over the remaining initial terms of the respective leases. In allocating the fair value of the identified intangible assets and liabilities of an acquired property, above-market and below-market in-place lease values are recorded based on the present value (using an interest rate which reflects the risks associated with the leases acquired) of the difference between (i) the contractual amounts to be paid pursuant to the in-place leases and (ii) estimated fair market lease rates from the perspective of a market participant for the corresponding in-place leases, measured, for above-market leases, over a period equal to the remaining non-cancelable term of the lease and, for below-market leases, over a period equal to the initial term plus any below market fixed rate renewal periods. The capitalized above-market lease values are amortized as a reduction of rental income over the remaining non-cancelable terms of the respective leases. The capitalized below-market lease values, also referred to as acquired lease obligations, are amortized as an increase to rental income over the initial terms of the respective leases. At December 31, 2023, our net intangible asset s total $ 9.1 million (net of $ 12.5 million accumulated amortization) and primarily consist of the value of in-place leases. At December 31, 2023, our net intangible value of in-place leases total $ 7.7 million (net of $ 11.0 million of accumulated amortization) and will be amortized over the remaining lease terms (aggregate weighted average of 5.3 years at December 31, 2023) and are expected to result in estimated aggregate amortization expense of, $ 1.6 million, $ 1.5 million, $ 1.3 million, $ 1.0 million and $ 2.4 million for 2024, 2025, 2026, 2027 and 2028 and thereafter, respectively. Amortization expense on intangible values of in place leases was $ 1.9 million for the year ended December 31, 2023, $ 2.1 million for the year ended December 31, 2022 and $ 2.6 million for the year ended December 31, 2021. The remaining amount of our net intangible assets primarily consists of above-market leases. At December 31, 2023, our net intangible value of above-market leases total $ 1.2 million (net of $ 1.4 million of accumulated amortization) and will be amortized over the remaining lease terms (aggregate weighted average of approximately 5.6 years at December 31, 2023) and are expected to result in estimated aggregate amortization offset to rental revenue of approximately $ 215,000 in 2024, $ 215,000 in 2025, $ 209,000 in 2026, $ 197,000 in 2027 and $ 370,000 in 2028 and thereafter. Amortization offset to rental revenue on intangible values of above-market leases was $ 246,000 , $ 247,000 and $ 205,000 for the years ended December 31, 2023, 2022 and 2021, respectively. Depreciation is computed using the straight-line method over the estimated useful lives of the buildings and capital improvements. The estimated original useful lives of our buildings range from 25 - 45 years and the estimated original useful lives of capital improvements ranges from 3 - 35 years. On a consolidated basis, depreciation expense was $ 24.6 million for the year ended December 31, 2023, $ 23.3 million for the year ended December 31, 2022 and $ 23.9 million for the year ended December 31, 2021.
Financing Assets	Financing Assets As discussed in Note 2 – Relationship with UHS and Related Party Transactions, on December 31, 2021 we entered into an asset purchase and sale agreement, as amended, with UHS and certain of its affiliates. Pursuant to the agreement, UHS purchased from us the real estate assets of the Inland Valley Campus of Southwest Healthcare System (“Inland Valley”) and transferred to us the real estate assets of Aiken Regional Medical Center (“Aiken”) and Canyon Creek Behavioral Health (“Canyon Creek”). In connection with this transaction, Aiken and Canyon Creek (as lessees), entered into a master lease and individual property leases (with us as lessor), as amended, for initial lease terms of approximately twelve years , ending on December 31, 2033. As a result of UHS' purchase option within the lease agreements of Aiken and Canyon Creek, the transaction is accounted for as a failed sale leaseback in accordance with U.S. GAAP and the properties acquired by us in connection with the asset purchase and sale agreement with UHS, as amended, were accounted for as financing arrangements and our consolidated balance sheets as of December 31, 2023 and December 31, 2022 include financing receivables related to this transaction of $ 83.3 million and $ 83.6 million, respectively. As of December 31, 2023, there are no indicators of impairment and the financing receivable will be assessed for recoverability in accordance with our asset impairment policy.
Cash and Cash Equivalents	Cash and Cash Equivalents We consider all highly liquid investment instruments with original maturities of three months or less to be cash equivalents.
Asset Impairment	Asset Impairment We review each of our properties for indicators that its carrying amount may not be recoverable. Examples of such indicators may include a significant decrease in the market price of the property, a change in the expected holding period for the property, a significant adverse change in how the property is being used or expected to be used based on the underwriting at the time of acquisition, an accumulation of costs significantly in excess of the amount originally expected for the acquisition or development of the property, or a history of operating or cash flow losses of the property. When such impairment indicators exist, we review an estimate of the future undiscounted net cash flows (excluding interest charges) expected to result from the real estate investment’s use and eventual disposition and compare that estimate to the carrying value of the property. We consider factors such as future operating income, trends and prospects, as well as the effects of leasing demand, competition and other factors. If our future undiscounted net cash flow evaluation indicates that we are unable to recover the carrying value of a real estate investment, an impairment loss is recorded to the extent that the carrying value exceeds the estimated fair value of the property. The evaluation of anticipated cash flows is highly subjective and is based in part on assumptions regarding future occupancy, rental rates and capital requirements that could differ materially from actual results in future periods. Since cash flows on properties considered to be long-lived assets to be held and used are considered on an undiscounted basis to determine whether the carrying value of a property is recoverable, our strategy of holding properties over the long-term directly decreases the likelihood of their carrying values not being recoverable and therefore requiring the recording of an impairment loss. If our strategy changes or market conditions otherwise dictate an earlier sale date, an impairment loss may be recognized and such loss could be material. If we determine that the asset fails the recoverability test, the affected assets must be reduced to their fair value. We generally estimate the fair value of rental properties utilizing a discounted cash flow analysis that includes projections of future revenues, expenses and capital improvement costs that a market participant would use based on the highest and best use of the asset, which is similar to the income approach that is commonly utilized by appraisers. In certain cases, we may supplement this analysis by obtaining outside broker opinions of value or third-party appraisals. In considering whether to classify a property as held for sale, we consider factors such as whether management has committed to a plan to sell the property, the property is available for immediate sale in its present condition for a price that is reasonable in relation to its current value, the sale of the property is probable, and actions required for management to complete the plan indicate that it is unlikely that any significant changes will made to the plan. If all the criteria are met, we classify the property as held for sale. Upon being classified as held for sale, depreciation and amortization related to the property ceases and it is recorded at the lower of its carrying amount or fair value less cost to sell. The assets and related liabilities of the property are classified separately on the consolidated balance sheets for the most recent reporting period. Only those assets held for sale that constitute a strategic shift or that will have a major effect on our operations are classified as discontinued operations.
Investments in Limited Liability Companies ("LLCs")	Investments in Limited Liability Companies (“LLCs”) In accordance with U.S. GAAP and guidance relating to accounting for investments and real estate ventures, we account for our unconsolidated investments in LLCs/LPs which we do not control using the equity method of accounting. The third-party members in these investments have equal voting rights with regards to issues such as, but not limited to: (i) divestiture of property; (ii) annual budget approval, and; (iii) financing commitments. These investments, which represent 33 % to 95 % non-controlling ownership interests, are recorded initially at our cost and subsequently adjusted for our net equity in the net income, cash contributions to, and distributions from, the investments. Pursuant to certain agreements, allocations of sales proceeds and profits and losses of some of the LLC investments may be allocated disproportionately as compared to ownership interests after specified preferred return rate thresholds have been satisfied. Distributions received from equity method investees in the consolidated statements of cash flows are classified based upon the nature of the distribution. Returns on investments are presented net of equity in income from unconsolidated investments as cash flows from operating activities. Returns of investments are classified as cash flows from investing activities. During the fourth quarter of 2021, we purchased the 5 % minority ownership interest, held by the third-party member in Grayson Properties, LP which owns the Texoma Medical Plaza, in which we previously held a noncontrolling majority ownership interest. As a result of this minority ownership purchase, we own 100 % of the LP and began to account for it on a consolidated basis effective November 1, 2021. Prior to November 1, 2021, the LP was accounted for on an unconsolidated basis pursuant to the equity method. The property’s assets and liabilities are recorded at the carrying amount of its previously held interest, plus the incremental cost which was allocated based upon relative fair values. A third-party appraisal was completed to determine the fair value of the property. There was no material impact on our net income as a result of the consolidation of this LP subsequent to the transaction. At December 31, 2023, we have non-controlling equity investments or commitments in four jointly-owned LLCs/LPs which own MOBs. As of December 31, 2023 we accounted for these LLCs/LPs on an unconsolidated basis pursuant to the equity method since they are not variable interest entities which we are the primary beneficiary nor do we have a controlling voting interest. The majority of these entities are joint-ventures between us and non-related parties that hold minority ownership interests in the entities. Each entity is generally self-sustained from a cash flow perspective and generates sufficient cash flow to meet its operating cash flow requirements and service the third-party debt (if applicable) that is non-recourse to us. Although there is typically no ongoing financial support required from us to these entities since they are cash-flow sufficient, we may, from time to time, provide funding for certain purposes such as, but not limited to, significant capital expenditures, leasehold improvements and debt financing. Although we are not obligated to do so, if approved by us at our sole discretion, additional cash funding is typically advanced as equity or member loans. These entities maintain property insurance on the properties. An other-than-temporary impairment of an investment in an unconsolidated LLC is recognized when the carrying value of the investment is not considered recoverable based on evaluation of the severity and duration of the decline in value, including projected declines in cash flow. To the extent impairment has occurred, the excess carrying value of the asset over its estimated fair value is charged to income.
Federal Income Taxes	Federal Income Taxes No provision has been made for federal income tax purposes since we qualify as a real estate investment trust under Sections 856 to 860 of the Internal Revenue Code of 1986, and intend to continue to remain so qualified. To qualify as a REIT, we must meet certain organizational and operational requirements, including a requirement to distribute at least 90 % of our annual REIT taxable income to shareholders. As a REIT, we generally will not be subject to federal, state or local income tax on income that we distribute as dividends to our shareholders. We are subject to a federal excise tax computed on a calendar year basis. The excise tax equals 4 % of the amount by which 85% of our ordinary income plus 95% of any capital gain income for the calendar year exceeds cash distributions during the calendar year, as defined. No provision for excise tax has been reflected in the financial statements as no tax was due. Earnings and profits, which determine the taxability of dividends to shareholders, will differ from net income reported for financial reporting purposes due to the differences for federal tax purposes in the cost basis of assets and in the estimated useful lives used to compute depreciation and the recording of provision for impairment losses. The aggregate gross cost basis and net book value of the properties for federal income tax purposes are approximately $710 million (unaudited) and $ 422 million (unaudited), respectively, at December 31, 2023. The aggregate cost basis and net book value of the properties for federal income tax purposes were approximately $ 681 million (unaudited) and $ 406 million (unaudited), respectively, at December 31, 2022.
Stock-Based Compensation	Stock-Based Compensation We expense the grant-date fair value of restricted stock awards over the vesting period. We recognize the grant-date fair value of equity-based compensation and account for these transactions using the fair-value based method. The expense associated with share-based compensation arrangements is a non-cash charge. In the Consolidated Statements of Cash Flows, stock-based compensation expense is an adjustment to reconcile net income to cash provided by operating activities.
Fair Value	Fair Value Fair value is a market-based measurement, not an entity-specific measurement and determined based upon the assumptions that market participants would use in pricing the asset or liability. As a basis for considering market participant assumptions in fair value measurements, accounting requirements establish a fair value hierarchy that distinguishes between market participant assumptions based on market data obtained from sources independent of the reporting entity (observable inputs that are classified within Level 1 and 2 of the hierarchy) and the reporting entity’s own assumptions about market participant assumptions (unobservable inputs classified within Level 3 of the hierarchy). In instances when it is necessary to establish the fair value of our real estate investments and investments in LLCs we use unobservable inputs which are typically based on our own assumptions. The fair value of our real estate investments, components of real estate investments and debt assumed in conjunction with acquisition and impairment activity, are considered to be Level 3 valuations as they are primarily based upon an income capitalization approach. Significant inputs into the models used to determine fair value of real estate investments and components of real estate investments include future cash flow projections, holding period, terminal capitalization rate and discount rates. Additionally, the fair value of land takes into consideration comparable sales, as adjusted for site specific factors. The fair value of real estate investments is based upon significant judgments made by management, and accordingly, we typically obtain assistance from third party valuation specialists. Significant inputs into the models used to determine the fair value of assumed mortgages included the outstanding balance, term, stated interest rate and current market rate of the mortgage. The carrying amounts reported in the balance sheet for cash, receivables, and short-term borrowings approximate their fair values due to the short-term nature of these instruments. Accordingly, these items are excluded from the fair value disclosures included elsewhere in these notes to the consolidated financial statements.
Concentration of Revenues	Concentration of Revenues The rental revenue earned pursuant to the lease on McAllen Medical Center, which is leased to a related party (see Note 2), generated approximately 9 % during each of 2023 and 2022 and approximately 10 % during 2021, of our consolidated revenues.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with generally accepted accounting principles in the United States of America requires us to make estimates and assumptions that affect the amounts reported in our consolidated financial statements and accompanying notes. Actual results could differ from those estimates.
New Accounting Standards	New Accounting Standards Except as noted below there were no new accounting pronouncements that impacted or are expected to impact us. Reference Rate Reform In March 2020, the FASB issued an accounting standard classified under FASB ASC Topic 848, “Reference Rate Reform.” The amendments in this update contain practical expedients for reference rate reform related activities that impact debt, leases, derivatives and other contracts. The guidance in ASC 848 is optional and may be elected over time as reference rate reform activities occur. Beginning in the first quarter of 2020, we elected to apply the hedge accounting expedients related to probability and the assessments of effectiveness for future LIBOR-indexed cash flows to assume that the index upon which future hedged transactions will be based matches the index on the corresponding derivatives. Application of these expedients preserves the presentation of derivatives consistent with past presentation. We will continue to evaluate the impact of the guidance and may apply other elections as applicable as additional changes in the market occur. In December 2022, the FASB issued ASU 2022-06, Deferral of the Sunset Date of Topic 848 (“ASU 2022-06”) which was issued to defer the sunset date of Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform to December 31, 2024. ASU 2022-06 is effective immediately for all companies. ASU 2022-06 had no impact on our condensed consolidated financial statements for the year ended December 31, 2023.

Relationship with UHS and Rel_2

Relationship with UHS and Related Party Transactions (Tables)	12 Months Ended
	Dec. 31, 2023
Related Party Transactions [Abstract]
Existing Lease Terms and Renewal Options for Each of UHS Hospital Facilities	The table below details the existing lease terms and renewal options for each of the hospital leases that are related to UHS as of January 1, 2024, co nsisting of three acute care hospitals and three behavioral health hospitals: Hospital Name Annual End of Renewal McAllen Medical Center $ 5,485,000 December, 2026 5 (a) Wellington Regional Medical Center $ 6,639,000 December, 2026 5 (b) Aiken Regional Medical Center/Aurora Pavilion Behavioral Health Services $ 4,072,000 December, 2033 35 (c) Canyon Creek Behavioral Health $ 1,841,000 December, 2033 35 (c) Clive Behavioral Health $ 2,775,000 December, 2040 50 (d) (a) UHS has one 5-year renewal option at existing lease rates (through 2031 ). (b) UHS has one 5-year renewal option at fair market value lease rates (through 2031 ; see additional disclosure below). The annual rental will increase by 2.5 % on an annual compounded basis on each January 1 st through 2026. (c) UHS has seven 5-year renewal options at fair market value lease rates ( 2034 through 2068 ). The annual rental rate will increase by 2.25 % on a cumulative and compounded basis on each January 1 st through 2033 . (d) The UHS-related joint venture has five 10-year renewal options; the first three of the five 10-year renewal options will be at computed lease rates as stipulated in the lease ( 2041 through 2070 ) and the last two 10-year renewal options will be at fair market lease rates ( 2071 through 2090 ). On each January 1 st through 2040 (and potentially through 2070 if the first three of five, 10-year renewal options are exercised), the annual rental will increase by 2.75 % on a cumulative and compounded basis. Upon the December 31, 2021 expiration of the leas e on Wellington Regional Medical Center located in West Palm Beach, Florida, a wholly-owned subsidiary of UHS exercised its fair market value renewal option and renewed the lease for a 5 -year term scheduled to expire on December 31, 2026. Effective January 1, 2023, the annual fair market value lease rate for this hospital, which was payable to us monthly, was $ 6.5 million (there is no longer a bonus rental component of the lease payment). On January 1, 2024 the annual rent increased to $ 6.6 million and on each January 1 st thereafter through 2026, the annual rent will increase by 2.50 % on a cumulative and compounded basis. Pursuant to the terms of the hospital’s previous lease, we earned aggregate lease revenue of $ 5.5 million during the year ended December 31, 2021, (consisting of $ 3.0 million of base rental and $ 2.5 million of bonus rental).

Lease Accounting (Tables)

Lease Accounting (Tables)	12 Months Ended
	Dec. 31, 2023
Leases [Abstract]
Components of the "Lease Revenue - UHS facilities" and "Lease Revenue - Non-related Parties" Captions	The components of the “Lease revenue – UHS facilities” and “Lease revenue – Non-related parties” captions for the years ended 2023, 2022 and 2021 are disaggregated below (in thousands). Base rents are primarily stated rent amounts provided for under the leases that are recognized on a straight-line basis over the term of the lease. Bonus rents and tenant reimbursements represent amounts where tenants are contractually obligated to pay an amount that is variable in nature. Year Ended December 31, 2023 2022 2021 UHS Facilities: Base rents $ 26,173 $ 24,485 $ 21,498 Bonus rents (a.) 2,953 2,801 6,906 Tenant reimbursements 3,497 2,668 1,492 Lease Revenue - UHS facilities $ 32,623 $ 29,954 $ 29,896 Non-related parties: Base rents $ 42,159 $ 40,533 $ 41,880 Tenant reimbursements 12,834 11,471 10,444 Lease Revenue - Non-related parties $ 54,993 $ 52,004 $ 52,324
Schedule of Minimum Future Base Rents from Non-Cancelable Leases (Topic 842)	Minimum future base rents from non-cancelable leases related to properties included in our financial statements on a consolidated basis, excluding increases resulting from changes in the consumer price index, bonus rents and the impact of straight-line rent adjustments, are as follows (amounts in thousands): For the year ended December 31, Amount 2024 $ 76,221 2025 70,064 2026 63,358 2027 43,935 2028 36,586 Thereafter 151,894 Total minimum base rents $ 442,058
Schedule of Supplemental Balance Sheet Information Related to Leases	Supplemental balance sheet information related to leases was as follows (in thousands): December 31, 2023 Operating Leases Right-of-use land assets, net-operating leases $ 10,946 Ground lease liabilities, net $ 10,946 Weighted Average remaining lease term, years Operating leases 56.3 Weighted Average discount rate Operating leases 6.29 %
Schedule of Maturities of lease liabilities	Maturities of lease liabilities are as follows (amounts in thousands): Year ended December 31: 2024 $ 704 2025 704 2026 704 2027 704 2028 704 Later years 36,027 Total undiscounted lease payments $ 39,547 Less imputed interest 28,601 Total $ 10,946

Debt and Financial Instruments

Debt and Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2023
Debt Disclosure [Abstract]
Summary of Required Compliance Ratios Giving Effect to New Covenants in Credit Agreements	The following table includes a summary of the required compliance ratios at December 31, 2023 and 2022, giving effect to the covenants contained in the Credit Agreements in effect on the respective dates (dollar amounts in thousands): Covenant December 31, 2023 December 31, 2022 Tangible net worth $ 125,000 $ 191,824 $ 219,654 Total leverage < 60 % 44.5 % 42.9 % Secured leverage < 30 % 4.1 % 5.6 % Unencumbered leverage < 60 % 44.2 % 41.8 % Fixed charge coverage > 1.50 x 3.1 x 4.3 x
Outstanding Mortgages, Excluding Net Debt Premium	As indicated on the following table, we have various mortgages, all of which are non-recourse to us and are not cross-collateralized, included on our consolidated balance sheet as of December 31, 2023 and 2022 (amounts in thousands): As of 12/31/2023 As of 12/31/2022 Facility Name Interest Maturity Outstanding Outstanding Desert Valley Medical Center fixed rate mortgage loan (b.) 3.62 % January, 2023 $ - $ 4,194 2704 North Tenaya Way fixed rate mortgage loan (c.) 4.95 % November, 2023 - 6,252 Summerlin Hospital Medical Office Building III fixed 4.03 % April, 2024 12,301 12,558 Tuscan Professional Building fixed rate mortgage loan 5.56 % June, 2025 1,060 1,719 Phoenix Children’s East Valley Care Center fixed rate 3.95 % January, 2030 7,930 8,203 Rosenberg Children's Medical Plaza fixed rate mortgage loan 4.42 % September, 2033 11,771 12,027 Total, excluding net debt premium and net financing fees 33,062 44,953 Less net financing fees ( 199 ) ( 268 ) Plus net debt premium - 40 Total mortgage notes payable, non-recourse to us, net $ 32,863 $ 44,725 (a.) All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity. (b.) This $ 4.2 million fixed rate mortgage loan was fully repaid on January 3, 2023, utilizing borrowings under our Credit Agreement. (c.) This $ 6.3 million fixed rate mortgage loan was fully repaid on November 1, 2023, utilizing borrowings under our Credit Agreement. (d.) This loan is scheduled to mature within the next twelve months, at which time we will either refinance pursuant to a new mortgage loan or repay the mortgage balance in full utilizing borrowings under our Credit Agreement.
Aggregate Consolidated Scheduled Debt Repayments	As of December 31, 2023, our aggregate consolidated scheduled debt repayments (including mortgages) are as follows (amounts in thousands): 2024 $ 13,550 2025 (a.) 327,539 2026 601 2027 626 2028 653 Later 16,693 Total $ 359,662 (a.) Includes assumed repayment of $ 326.6 million of outstanding borrowings under the terms of our $ 375 million revolving credit agreement scheduled to mature in July, 2025 .

Summarized Financial Informat_2

Summarized Financial Information of Equity Affiliates (Tables)	12 Months Ended
	Dec. 31, 2023
Equity Method Investments and Joint Ventures [Abstract]
Limited Liability Companies Accounted for Under Equity Method	The following property table represents the four LLCs or LPs in which we own a non-controlling interest and were accounted for under the equity method as of December 31, 2023: Name of LLC/LP Ownership Property Owned by LLC/LP Suburban Properties 33 % St. Matthews Medical Plaza II Brunswick Associates (a.)(b.) 74 % Mid Coast Hospital MOB FTX MOB Phase II (c.) 95 % Forney Medical Plaza II Grayson Properties II (d.)(e.) 95 % Texoma Medical Plaza II (a.) This LLC has a third-party term loan of $ 8.5 million, which is non-recourse to us, outstanding as of December 31, 2023. (b.) We are the lessee with a third party on a ground lease for land. (c.) During the first quarter of 2021, this LP paid off its $ 4.7 million mortgage loan, upon maturity, utilizing pro rata equity contributions from the limited partners as well as a $ 3.5 million member loan from us to the LP which was funded utilizing borr owings from our revolving credit agreement. During the first quarter of 2023, the LP repaid $ 175,000 of the member loan and the remaining $ 3.3 million member loan balance was converted to an equity investment in the LP. (d.) This LP constructed, owns and operates the Texoma Medical Plaza II, on which construction substantially completed in December 2020. The MOB is located in Denison, Texas, on the campus of a hospital owned and operated by a wholly-owned subsidiary of UHS. We have committed to invest up to $ 5.2 million in eq uity and debt financing, $ 2.2 million of which has been funded as of December 31, 2023. This LP entered into a third-party construction loan commitment, which is non-recourse to us, which has an outstanding balance of $ 12.8 million as of December 31, 2023. Monthly principal and interest payments on this loan commenced on January 1, 2023. During the first quarter of 2024, $ 5.7 million of the third-party construction loan was repa id utilizing pro rata equity contributions from the partners. The third-party partner's share of the pro rata equity contributions was partially funded with a six-month, $ 128,000 partner loan from us. Our share of the pro rata equity contributions, as well as the third-party partner loan, were funded utilizing borrowings from our revolving credit agreement. As a result of the repayment of a portion of the construction loan, an associated $ 3.1 million letter of credit was terminated. We are the lessee with a UHS-related party for the land related to this property.
Combined Statements of Income for LLCs/LPs Accounted Under Equity Method	Below are the combined statements of income for the four LLCs/LPs accounted for under the equity method at December 31, 2023, 2022 and 2021. The data for the year ended December 31, 2021 includes financial results for the above-mentioned Texoma Medical Plaza in which we purchased the minority ownership interest during the fourth quarter of 2021, for the period of January through October of 2021 only (during which it was accounted for under the equity method). For the Year Ended December 31, 2023 2022 2021 (amounts in thousands) Revenues $ 8,505 $ 8,204 $ 10,575 Operating expenses 3,351 3,177 4,093 Depreciation and amortization 1,873 1,853 2,198 Interest, net 825 1,061 1,721 Net income $ 2,456 $ 2,113 $ 2,563 Our share of net income $ 1,207 $ 1,191 $ 1,796
Combined Balance Sheets for LLCs/LPs Accounted Under Equity Method	Below are the combined balance sheets for the four LLCs/LPs that were accounted for under the equity method as of December 31, 2023 and 2022: December 31, 2023 2022 (amounts in thousands) Net property, including construction in progress $ 28,488 $ 29,573 Other assets (a.) 4,667 4,334 Total assets $ 33,155 $ 33,907 Other liabilities (a.) $ 2,074 $ 2,338 Mortgage notes payable, non-recourse to us 21,206 21,802 Advances payable to us (b.) — 3,500 Equity 9,875 6,267 Total liabilities and equity $ 33,155 $ 33,907 Investments in LLCs before amounts included in accrued expenses and other liabilities 9,102 9,282 Amounts included in accrued expenses and other liabilities ( 1,729 ) ( 1,709 ) Our share of equity in LLCs, net $ 7,373 $ 7,573 (a.) Other assets and other liabilities as of December 31, 2023 and 2022, include approximately $ 651,000 and $ 654,000 , respectively, of right-of-use land assets and right-of-use land liabilities related to ground leases whereby the LLC/LP is the lessee, with third parties, including subsidiaries of UHS. (b.) This 7.25% member loan to FTX MOB Phase II, LP had a maturity date of March 1, 2023 . Upon the maturity date, the LP repaid $ 175,000 of the member loan to us and the remaining balance of $ 3.3 million was converted to an equity contribution by us.
Aggregate Principal Amounts due on Mortgage and Construction Notes Payable by Unconsolidated LLC's Accounted Under Equity Method	As of December 31, 2023, aggregate principal amounts due on mortgage notes payable by unconsolidated LLCs, which are accounted for under the equity method and are non-recourse to us, are as follows (amounts in thousands): 2024 $ 613 2025 12,704 2026 293 2027 301 2028 310 2029 and thereafter 6,985 Total $ 21,206 Mortgage Loan Balance (a.) Name of LLC/LP 12/31/2023 12/31/2022 Maturity Date Brunswick Associates (2.80% fixed rate mortgage loan) $ 8,453 $ 8,727 December, 2030 Grayson Properties II (3.70% fixed rate construction loan) (b.) 12,753 13,075 June, 2025 $ 21,206 $ 21,802 (a.) All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity. (b.) This construction loan required interest on the outstanding principal balance to be paid on a monthly basis through December 1, 2022. On January 1, 2023, monthly principal and interest payments on the loan commenced. During the first quarter of 2024, $ 5.7 million of the third-party construction loan was repa id utilizing pro rata equity contributions from the partners, as discussed above. As a result of the repayment of a portion of the construction loan, an associated $ 3.1 million letter of credit was terminated.

Organization and Summary of S_3

Organization and Summary of Significant Accounting Policies - Additional Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) Property	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Feb. 27, 2024 Property State
Significant Accounting Policies [Line Items]
Net intangible assets	$ 9,110	$ 9,447
Intangible assets, accumulated amortization	$ 12,500	15,400
Intangible assets amortized over weighted average remaining lease term	56 years 3 months 18 days
Depreciation expense	$ 24,600	23,300	$ 23,900
Purchase price			$ 3,092
Federal excise tax rate when amount of 85% of ordinary income plus 95% of any capital gain income exceeds cash distributions	4%
Gross cost basis of properties for federal income tax purposes (Unaudited)	$ 710,000	681,000
Net book value of the properties for federal income tax purposes (Unaudited)	$ 422,000	406,000
Grayson Properties
Significant Accounting Policies [Line Items]
Minority ownership interest held by a third-party			5%
Ownership percentage upon completion of the minority ownership purchase	100%		100%
Aiken Regional Medical Center and Canyon Creek Behavioral Health
Significant Accounting Policies [Line Items]
Initial lease term on property	12 years		12 years
Fair market value of real estate assets received	$ 83,300	83,600
Minimum
Significant Accounting Policies [Line Items]
Percentage of annual REIT taxable income that should be distributed to remain exempt from federal income taxes	90%
Minimum | 4 Unconsolidated Limited Liability Companies / Limited Partner
Significant Accounting Policies [Line Items]
Non-controlling equity interest, ownership percentage	33%
Maximum | 4 Unconsolidated Limited Liability Companies / Limited Partner
Significant Accounting Policies [Line Items]
Non-controlling equity interest, ownership percentage	95%
Buildings | Minimum
Significant Accounting Policies [Line Items]
Estimated original useful lives of property plant and equipment	25 years
Buildings | Maximum
Significant Accounting Policies [Line Items]
Estimated original useful lives of property plant and equipment	45 years
Capital Improvements | Minimum
Significant Accounting Policies [Line Items]
Estimated original useful lives of property plant and equipment	3 years
Capital Improvements | Maximum
Significant Accounting Policies [Line Items]
Estimated original useful lives of property plant and equipment	35 years
In Place Leases
Significant Accounting Policies [Line Items]
Net intangible assets	$ 7,700
Intangible assets, accumulated amortization	$ 11,000
Intangible assets amortized over weighted average remaining lease term	5 years 3 months 18 days
Intangible assets, estimated aggregate amortization expenses for 2024	$ 1,600
Intangible assets, estimated aggregate amortization expenses for 2025	1,500
Intangible assets, estimated aggregate amortization expenses for 2026	1,300
Intangible assets, estimated aggregate amortization expenses for 2027	1,000
Intangible assets, estimated aggregate amortization expenses for 2028 and thereafter	2,400
Amortization expense, intangible assets	2,100	1,900	$ 2,600
Above-Market Leases
Significant Accounting Policies [Line Items]
Net intangible assets	1,200
Intangible assets, accumulated amortization	$ 1,400
Intangible assets amortized over weighted average remaining lease term	5 years 7 months 6 days
Intangible assets, estimated aggregate amortization expenses for 2024	$ 215,000
Intangible assets, estimated aggregate amortization expenses for 2025	215,000
Intangible assets, estimated aggregate amortization expenses for 2026	209,000
Intangible assets, estimated aggregate amortization expenses for 2027	197,000
Intangible assets, estimated aggregate amortization expenses for 2028 and thereafter	370,000
Amortization expense, intangible assets	$ 246,000	$ 247,000	$ 205,000
McAllen Medical Center | Customer Concentration Risk | Revenues
Significant Accounting Policies [Line Items]
Percentage of rental revenue	9%	9%	10%
Medical office buildings | Limited Liability Companies
Significant Accounting Policies [Line Items]
Number of real estate investments | Property	4
Subsequent Event
Significant Accounting Policies [Line Items]
Number of real estate investments | Property				76
Number of states that real estate investments are located | State				21
Subsequent Event | Hospitals
Significant Accounting Policies [Line Items]
Number of real estate investments | Property				6
Subsequent Event | Hospitals | Acute Care
Significant Accounting Policies [Line Items]
Number of real estate investments | Property				3
Subsequent Event | Hospitals | Behavioral health
Significant Accounting Policies [Line Items]
Number of real estate investments | Property				3
Subsequent Event | Mission and Weslaco Freestanding Emergency Departments
Significant Accounting Policies [Line Items]
Number of real estate investments | Property				4
Subsequent Event | Medical office buildings | Limited Liability Companies ("LLCs")/ Limited Liability Partnerships ("LPs")
Significant Accounting Policies [Line Items]
Number of real estate investments | Property				4
Subsequent Event | Preschool and childcare Centers
Significant Accounting Policies [Line Items]
Number of real estate investments | Property				4

Relationship with UHS and Rel_3

Relationship with UHS and Related Party Transactions - Additional Information (Detail1)	12 Months Ended			72 Months Ended
	Dec. 31, 2023 Hospital Property	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2023 Hospital
Universal Health Services, Inc
Related Party Transaction [Line Items]
Percentage of lease guaranteed	52%
Number of acute care hospital leased	3			3
Number of behavioral health care hospital leased	3			3
Number of medical office buildings and free standing emergency departments | Property	21
Universal Health Services, Inc | Revenues | Customer Concentration Risk
Related Party Transaction [Line Items]
Percentage of revenues generated from leases and tenants	25%	26%
Universal Health Services, Inc | Revenues | Customer Concentration Risk | Tenants
Related Party Transaction [Line Items]
Percentage of revenues generated from leases and tenants	41%	40%	37%	37%
Catholic Health Initiatives Iowa
Related Party Transaction [Line Items]
Percentage of lease guaranteed	48%

Relationship with UHS and Rel_4

Relationship with UHS and Related Party Transactions - Additional Information (Detail 2) - USD ($) $ in Millions	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Aiken Regional Medical Center and Canyon Creek Behavioral Health
Related Party Transaction [Line Items]
Fair market value of real estate assets received		$ 83.3	$ 83.6
Subsidiary | Universal Health Services, Inc
Related Party Transaction [Line Items]
Financing receivable		83.3	$ 83.6
Subsidiary | Asset Purchase and Sale Agreement | Universal Health Services, Inc
Related Party Transaction [Line Items]
Cash received for sale of real estate asset	$ 4.1
Gain on sale of real estate assets		$ 68.4		$ 68.4
Subsidiary | Inland Valley Campus of Southwest Healthcare System | Asset Purchase and Sale Agreement | Universal Health Services, Inc
Related Party Transaction [Line Items]
Fair market value of real estate asset sold				79.6
Cash received for sale of real estate asset				4.1
Subsidiary | Aiken Regional Medical Center and Canyon Creek Behavioral Health | Asset Purchase and Sale Agreement | Universal Health Services, Inc
Related Party Transaction [Line Items]
Fair market value of real estate assets received	83.7			83.7
Subsidiary | Wildomar, California | Inland Valley Campus of Southwest Healthcare System | Asset Purchase and Sale Agreement | Universal Health Services, Inc
Related Party Transaction [Line Items]
Fair market value of real estate asset sold	79.6			79.6
Subsidiary | Aiken, South Carolina | Aiken Regional Medical Center | Asset Purchase and Sale Agreement | Universal Health Services, Inc
Related Party Transaction [Line Items]
Fair market value of real estate assets received	57.7			57.7
Subsidiary | Temple, Texas | Canyon Creek Behavioral Health | Asset Purchase and Sale Agreement | Universal Health Services, Inc
Related Party Transaction [Line Items]
Fair market value of real estate assets received	$ 26			$ 26

Relationship with UHS and Rel_5

Relationship with UHS and Related Party Transactions - Additional Information (Detail 3)		1 Months Ended	3 Months Ended		12 Months Ended
		May 31, 2021 USD ($) Time	Sep. 30, 2023 USD ($) ft²	Mar. 31, 2023 USD ($) ft²	Dec. 31, 2023 USD ($) Property Lease Time Hospital Bed RenewalOption	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Mar. 31, 2022 USD ($)	Jan. 31, 2022 ft²
Related Party Transaction [Line Items]
Number of bed facility | Bed					100
Aggregate lease payments for 2023					$ 704,000
Aggregate lease payments for 2024					704,000
Aggregate lease payments for 2025					704,000
Aggregate lease payments for 2026					704,000
Aggregate lease payments for 2027					704,000
Aggregate lease payments for thereafter					$ 36,027,000
Annual advisory fee as percentage of average invested real estate assets					0.70%	0.70%	0.70%
Grayson Properties
Related Party Transaction [Line Items]
Minority ownership interest held by a third-party							5%
Ownership percentage upon completion of the minority ownership purchase					100%		100%
Minority ownership interest							$ 3,100,000
McAllen Medical Center
Related Party Transaction [Line Items]
Initial rent			$ 624,000
Rentable square feet | ft²			79,500
Payment to acquire business			$ 7,600,000
Percentage of lease guaranteed			100%
McAllen Medical Center | Bonus Rents
Related Party Transaction [Line Items]
Lease revenue					$ 2,953,000	$ 2,801,000	$ 6,906,000
Palm Beach, Florida | Wellington Regional Medical Center
Related Party Transaction [Line Items]
Lessee operating lease, existence of option to extend							true
Monthly lease rent receivable							$ 6,300,000
Lease revenue					6,500,000	6,600,000	$ 5,500,000
Percentage of annual rental increase on cumulative and compound basis							2.50%
Operating lease renewal term							5 years
Palm Beach, Florida | Wellington Regional Medical Center | Bonus Rents
Related Party Transaction [Line Items]
Lease revenue							$ 2,500,000
Palm Beach, Florida | Wellington Regional Medical Center | Base Rents
Related Party Transaction [Line Items]
Lease revenue							$ 3,000,000
Aiken Regional Medical Center
Related Party Transaction [Line Items]
Monthly lease rent receivable					4,000,000	3,900,000		$ 4,000,000
Canyon Creek Behavioral Health
Related Party Transaction [Line Items]
Monthly lease rent receivable					1,800,000	1,800,000		1,800,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health
Related Party Transaction [Line Items]
Fair market value of real estate assets received					$ 83,300,000	83,600,000
Initial lease term on property					12 years		12 years
Lease expiration date							Dec. 31, 2033
Number of term renewal options | Time					7
Lease renewal term					5 years
Monthly lease rent receivable					$ 5,800,000	5,700,000		$ 5,800,000
Lease payments expected					5,500,000	5,500,000
Lease revenue							$ 4,500,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Bonus Rents
Related Party Transaction [Line Items]
Lease revenue					$ 0		1,900,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Base Rents
Related Party Transaction [Line Items]
Lease revenue							2,600,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Southwest Healthcare System Inland Valley Campus
Related Party Transaction [Line Items]
Lease revenue							4,500,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Southwest Healthcare System Inland Valley Campus | Bonus Rents
Related Party Transaction [Line Items]
Lease revenue							1,900,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Southwest Healthcare System Inland Valley Campus | Base Rents
Related Party Transaction [Line Items]
Lease revenue							2,600,000
Universal Health Services, Inc
Related Party Transaction [Line Items]
Number of medical office buildings and free standing emergency departments | Property					21
Number of term renewal options | Time		2
Lease revenue	[1]				$ 32,623,000	$ 29,954,000	29,896,000
Option to renew lease, notice period prior to termination date of current term					90 days
Period to purchase respective leased facilities at same price after lease terms						180 days
Renewal period of respective leased facilities at same price after lease terms					180 days
Number of ground leases | Lease					13
Aggregate lease payments for 2023					$ 571,000
Aggregate lease payments for 2024					571,000
Aggregate lease payments for 2025					571,000
Aggregate lease payments for 2026					571,000
Aggregate lease payments for 2027					571,000
Aggregate lease payments for thereafter					$ 31,900,000
Percentage ownership of outstanding shares					5.70%	5.70%
Percentage of lease guaranteed					52%
Universal Health Services, Inc | Minimum
Related Party Transaction [Line Items]
Remaining lease terms on ground leases					26 years
Universal Health Services, Inc | Maximum
Related Party Transaction [Line Items]
Remaining lease terms on ground leases					75 years
Universal Health Services, Inc | Bonus Rents
Related Party Transaction [Line Items]
Lease revenue	[2]				$ 2,953,000	$ 2,801,000	6,906,000
Universal Health Services, Inc | Base Rents
Related Party Transaction [Line Items]
Lease revenue					$ 26,173,000	24,485,000	21,498,000
Universal Health Services, Inc | Acute Care Hospitals
Related Party Transaction [Line Items]
Number of hospitals operating lease terms of existing and renewal options | Hospital					3
Universal Health Services, Inc | Wellington Regional Medical Center
Related Party Transaction [Line Items]
Percentage of annual rental increase on cumulative and compound basis					2.50%
Renewal options term at fair market value lease rates					5 years
Renewal options at fair market value lease rates expiration year					2031
Universal Health Services, Inc | McAllen Medical Center
Related Party Transaction [Line Items]
Initial lease term on property			12 years
Lease expiration date			Aug. 31, 2035
Universal Health Services, Inc | Clive, Iowa | Clive Behavioral Health
Related Party Transaction [Line Items]
Lessee operating lease, existence of option to extend					true
Number of term renewal options | Time					5
Percentage of annual rental increase on cumulative and compound basis					2.75%
Option to renew lease, notice period prior to termination date of current term					270 days
Initial lease term on property					20 years
Number of lease renewal option exercised | Time					3
Renewal option term					10 years
Operating Lease Additional Number Of Renewal Options At Fair Market Value Lease Rates | RenewalOption					2
Renewal options term at fair market value lease rates					10 years
Period to purchase respective leased facilities prior to end of lease term or renewal terms					270 days
Universal Health Services, Inc | Clive, Iowa | Clive Behavioral Health | Minimum
Related Party Transaction [Line Items]
Renewal options at fair market value lease rates expiration year					2071
Universal Health Services, Inc | Clive, Iowa | Clive Behavioral Health | Maximum
Related Party Transaction [Line Items]
Renewal options at fair market value lease rates expiration year					2090
Universal Health Services, Inc | Palm Beach, Florida | Wellington Regional Medical Center
Related Party Transaction [Line Items]
Monthly lease rent receivable							6,500,000
Lease revenue							5,500,000
Amount of annual rental increase on cumulative and compound basis							$ 6,600,000
Percentage of annual rental increase on cumulative and compound basis							2.50%
Operating lease renewal term					5 years
Universal Health Services, Inc | Palm Beach, Florida | Wellington Regional Medical Center | Bonus Rents
Related Party Transaction [Line Items]
Lease revenue							$ 2,500,000
Universal Health Services, Inc | Palm Beach, Florida | Wellington Regional Medical Center | Base Rents
Related Party Transaction [Line Items]
Lease revenue							3,000,000
Universal Health Services, Inc | Ground Lease and Master Flex-lease Agreement | Reno, Nevada | Sierra Medical Plaza I
Related Party Transaction [Line Items]
Cost Of Medical Office Building Incurred				$ 35,000,000
Rentable square feet | ft²				86,000					86,000
Cost of medical office building				$ 29,000,000
Percentage of rentable square feet				68%
Universal Health Services, Inc | Ground Lease and Master Flex-lease Agreement | Reno, Nevada | Sierra Medical Plaza I | Minimum
Related Party Transaction [Line Items]
Initial rent				$ 1,300,000
Fire Mesa Office Building
Related Party Transaction [Line Items]
Lease expiration date		Aug. 31, 2027
Payment to acquire business		$ 12,900,000
Lease percentage		100%
Universal Health Services of Delaware Inc
Related Party Transaction [Line Items]
Advisory fee					$ 5,300,000	5,100,000	4,400,000
Average invested real estate assets					$ 757,000,000	$ 728,000,000	$ 629,000,000
Catholic Health Initiatives Iowa
Related Party Transaction [Line Items]
Percentage of lease guaranteed					48%
[1] Includes bonus rental on McAllen Medical Center, a UHS acute care hospital facility, o f $ 2,953 and $ 2,801 for the years ended December 31, 2023 and December 31, 2022, respectively, and includes bonus rental on three UHS acute care hospital facilities of $ 6,906 for the year ended December 31, 2021 . Includes bonus rental on McAllen Medical Center, a UHS acute care hospital facility of $ 2,953 and $ 2,801 for the years ended December 31, 2023 and 2022, respectively, and includes bonus rental on three UHS acute care hospital facilities of $ 6,906 for the year ended December 31, 2021. Please see disclosure below surrounding the December 31, 2021 asset purchase and sale transaction with UHS.

Relationship with UHS and Rel_6

Relationship with UHS and Related Party Transactions - Additional Information (Detail 4) - Revenues - Customer Concentration Risk - Universal Health Services, Inc	12 Months Ended			72 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2023
Related Party Transaction [Line Items]
Percentage of revenues generated from leases and tenants	25%	26%
Tenants
Related Party Transaction [Line Items]
Percentage of revenues generated from leases and tenants	41%	40%	37%	37%

Existing Lease Terms and Renewa

Existing Lease Terms and Renewal Options for Each of UHS Hospital Facilities (Detail) - Universal Health Services, Inc	12 Months Ended
	Dec. 31, 2023 USD ($)
McAllen Medical Center
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 5,485,000	[1]
End of Lease Term	2026-12	[1]
Renewal Term (years)	5 years	[1]
Wellington Regional Medical Center
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 6,639,000	[2]
End of Lease Term	2026-12	[2]
Renewal Term (years)	5 years	[2]
Aiken Regional Medical Center/Aurora Pavilion Behavioral Health Services
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 4,072,000	[3]
End of Lease Term	2033-12	[3]
Renewal Term (years)	35 years	[3]
Canyon Creek Behavioral Health
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 1,841,000	[3]
End of Lease Term	2033-12	[3]
Renewal Term (years)	35 years	[3]
Clive Behavioral Health Hospital
Operating Leased Assets [Line Items]
Annual Minimum Rent	$ 2,775,000	[4]
End of Lease Term	2040-12	[4]
Renewal Term (years)	50 years	[4]
[1] UHS has one 5-year renewal option at existing lease rates (through 2031 ). UHS has one 5-year renewal option at fair market value lease rates (through 2031 ; see additional disclosure below). The annual rental will increase by 2.5 % on an annual compounded basis on each January 1 st through 2026. UHS has seven 5-year renewal options at fair market value lease rates ( 2034 through 2068 ). The annual rental rate will increase by 2.25 % on a cumulative and compounded basis on each January 1 st through 2033 . The UHS-related joint venture has five 10-year renewal options; the first three of the five 10-year renewal options will be at computed lease rates as stipulated in the lease ( 2041 through 2070 ) and the last two 10-year renewal options will be at fair market lease rates ( 2071 through 2090 ). On each January 1 st through 2040 (and potentially through 2070 if the first three of five, 10-year renewal options are exercised), the annual rental will increase by 2.75 % on a cumulative and compounded basis.

Existing Lease Terms and Rene_2

Existing Lease Terms and Renewal Options for Each of UHS Hospital Facilities (Parenthetical) (Detail) - Universal Health Services, Inc	12 Months Ended
	Dec. 31, 2023 Renewaloptions
McAllen Medical Center
Operating Leased Assets [Line Items]
Number of renewal option at existing lease rates	1
Renewal option term at existing lease rates	5 years
Renewal option at existing lease rates expiration year	2031
Wellington Regional Medical Center
Operating Leased Assets [Line Items]
Percentage of annual rental increase	2.50%
Number of renewal options at fair market value lease rates	1
Renewal options term at fair market value lease rates	5 years
Renewal options at fair market value lease rates expiration year	2031
Aiken Regional Medical Center and Canyon Creek Behavioral Health
Operating Leased Assets [Line Items]
Percentage of annual rental increase on cumulative and compound basis	2.25%
Number of renewal options at fair market value lease rates	7
Renewal options term at fair market value lease rates	5 years
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Minimum
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2034
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Maximum
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2068
Clive Behavioral Health Hospital
Operating Leased Assets [Line Items]
Number of renewal options at fair market value lease rates	5
Renewal options term at fair market value lease rates	10 years
Clive Behavioral Health Hospital | First Three Year Renewal Options
Operating Leased Assets [Line Items]
Percentage of annual rental increase on cumulative and compound basis	2.75%
Clive Behavioral Health Hospital | Minimum | First Three Year Renewal Options
Operating Leased Assets [Line Items]
Renewal options at lease rate stipulated in lease expiration year	2041
Clive Behavioral Health Hospital | Minimum | Last Two Year Renewal Options
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2071
Clive Behavioral Health Hospital | Maximum | First Three Year Renewal Options
Operating Leased Assets [Line Items]
Renewal options at lease rate stipulated in lease expiration year	2070
Clive Behavioral Health Hospital | Maximum | Last Two Year Renewal Options
Operating Leased Assets [Line Items]
Renewal options at fair market value lease rates expiration year	2090

Purchase and Sale Transaction_2

Purchase and Sale Transaction, Acquisitions, Divestitures and New Construction - Additional Information (Detail)

1 Months Ended

3 Months Ended

12 Months Ended

Dec. 01, 2022

Mar. 31, 2022 USD ($) ft²

Jan. 31, 2022 USD ($) ft² Tenant Time

Dec. 31, 2023 USD ($) Time

Sep. 30, 2023 USD ($) ft²

Mar. 31, 2023 USD ($) ft²

Mar. 31, 2022 USD ($) ft² Subsidiary

Dec. 31, 2023 USD ($) Time

Dec. 31, 2022 USD ($) Disposition

Dec. 31, 2021 USD ($) Subsidiary

May 31, 2021 Time

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

(Loss)/gain on divestitures of real estate assets

$ (232,000)

$ 87,314,000

Number of dispositions | Disposition

0

Grayson Properties II LP

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Non-controlling equity interest, ownership percentage

[1],[2]

95%

95%

Aiken Regional Medical Center and Canyon Creek Behavioral Health

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Number of term renewal options | Time

7

7

Fair market value of real estate assets received

$ 83,300,000

$ 83,600,000

Term of lease

12 years

12 years

12 years

Lease expiration date

Dec. 31, 2033

Universal Health Services, Inc

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Number of term renewal options | Time

2

Option to renew lease, notice period prior to termination date of current term

90 days

Universal Health Services, Inc | Subsidiary

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Number of wholly-owned subsidiaries | Subsidiary

2

2

Financing receivable

$ 83,300,000

$ 83,300,000

$ 83,600,000

Asset Purchase and Sale Agreement | Universal Health Services, Inc | Subsidiary

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Cash received for sale of real estate asset

$ 4,100,000

Gain on sale of real estate assets

68,400,000

$ 68,400,000

Asset Purchase and Sale Agreement | Universal Health Services, Inc | Subsidiary | Inland Valley Campus of Southwest Healthcare System

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Fair market value of real estate asset sold

79,600,000

Cash received for sale of real estate asset

4,100,000

Asset Purchase and Sale Agreement | Universal Health Services, Inc | Subsidiary | Aiken Regional Medical Center and Canyon Creek Behavioral Health

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Fair market value of real estate assets received

83,700,000

83,700,000

Frederick, Maryland | Third-Party Tenant

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Payment to acquire business

$ 8,000,000

Percentage of lease

100%

Number of tenants | Tenant

3

Percentage of rentable square feet

72%

Number of term renewal options | Time

3

Renewal Term (years)

5 years

Rentable square feet | ft²

20,146

Double net lease agreement period

15 years

Initial lease terms

14 years

Wildomar, California | Asset Purchase and Sale Agreement | Universal Health Services, Inc | Subsidiary | Inland Valley Campus of Southwest Healthcare System

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Fair market value of real estate asset sold

79,600,000

79,600,000

Aiken, South Carolina | Asset Purchase and Sale Agreement | Universal Health Services, Inc | Subsidiary | Aiken Regional Medical Center

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Fair market value of real estate assets received

57,700,000

57,700,000

Temple, Texas | Asset Purchase and Sale Agreement | Universal Health Services, Inc | Subsidiary | Canyon Creek Behavioral Health

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Fair market value of real estate assets received

$ 26,000,000

$ 26,000,000

Denison Texas | Grayson Properties II LP

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Commitment to investment

2,200,000

2,200,000

Denison Texas | Grayson Properties II LP | Maximum

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Commitment to investment

$ 5,200,000

$ 5,200,000

Sierra Medical Plaza I | Reno, Nevada | Ground Lease and Master Flex-lease Agreement | Universal Health Services, Inc

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Percentage of rentable square feet

68%

Rentable square feet | ft²

86,000

86,000

Cost of medical office building

$ 29,000,000

Cost Of Medical Office Building Incurred

35,000,000

Sierra Medical Plaza I | Reno, Nevada | Ground Lease and Master Flex-lease Agreement | Universal Health Services, Inc | Minimum

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Initial rent

$ 1,300,000

Beaumont Heart And Vascular Center | Dearborn Michigan

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Payment to acquire business

$ 5,400,000

Percentage of lease

100%

Lease expiration date

Nov. 30, 2026

Percentage of lease escalations

2.5

Rentable square feet | ft²

17,621

17,621

McAllen Medical Center

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Payment to acquire business

$ 7,600,000

Rentable square feet | ft²

79,500

Initial rent

$ 624,000

McAllen Medical Center | Universal Health Services, Inc

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Renewal Term (years)

[3]

5 years

5 years

Term of lease

12 years

Lease expiration date

Aug. 31, 2035

McAllen Medical Center | McAllen, Texas

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Payment to acquire business

$ 7,600,000

Percentage of lease

100%

Term of lease

12 years

Lease expiration date

Aug. 31, 2035

Rentable square feet | ft²

79,500

Initial rent

$ 624,000

Specialty Facility In Corpus Christi Texas | Corpus Christi, Texas

Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]

Net of closing costs

$ 3,900,000

Divestiture generated loss

$ 232,000

$ 232,000

[1] This LP constructed, owns and operates the Texoma Medical Plaza II, on which construction substantially completed in December 2020. The MOB is located in Denison, Texas, on the campus of a hospital owned and operated by a wholly-owned subsidiary of UHS. We have committed to invest up to $ 5.2 million in eq uity and debt financing, $ 2.2 million of which has been funded as of December 31, 2023. This LP entered into a third-party construction loan commitment, which is non-recourse to us, which has an outstanding balance of $ 12.8 million as of December 31, 2023. Monthly principal and interest payments on this loan commenced on January 1, 2023. During the first quarter of 2024, $ 5.7 million of the third-party construction loan was repa id utilizing pro rata equity contributions from the partners. The third-party partner's share of the pro rata equity contributions was partially funded with a six-month, $ 128,000 partner loan from us. Our share of the pro rata equity contributions, as well as the third-party partner loan, were funded utilizing borrowings from our revolving credit agreement. As a result of the repayment of a portion of the construction loan, an associated $ 3.1 million letter of credit was terminated. We are the lessee with a UHS-related party for the land related to this property. UHS has one 5-year renewal option at existing lease rates (through 2031 ).

Purchase and Sale Transaction_3

Purchase and Sale Transaction, Acquisitions, Divestitures and New Construction - Additional Information (Detail 2) $ in Millions	1 Months Ended			12 Months Ended
	Nov. 30, 2021 USD ($)	Jun. 30, 2021 USD ($)	May 31, 2021 USD ($) Time	Dec. 31, 2021 USD ($)
Universal Health Services, Inc
Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]
Number of term renewal options | Time			2
Auburn Medical Office Building II
Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]
Sale price net of closing costs	$ 24.9
(Loss)/gain on divestitures of real estate assets				$ 15.2
Cash from sale proceeds held by qualified third party intermediary				17.6
Medical office buildings
Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]
Sale price net of closing costs		$ 3.2
(Loss)/gain on divestitures of real estate assets				$ 1.3
Fire Mesa Office Building | Universal Health Services, Inc
Purchase And Sale Transaction Acquisitions Divestitures And New Construction [Line Items]
Total purchase price			$ 12.9
Percentage of building area leased			100%
Renewal options period			5 years

Lease Accounting - Additional I

Lease Accounting - Additional Information (Detail)		3 Months Ended			12 Months Ended
		Dec. 31, 2023 USD ($) Time	Dec. 31, 2022 USD ($)	Mar. 31, 2022 USD ($) Subsidiary	Dec. 31, 2023 USD ($) Land Time	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($) Lease Subsidiary	May 31, 2021 Time
Leases Disclosure [Line Items]
Lessee in connection with ground leases for land | Land					15
Right-of-use land assets		$ 10,946,000	$ 11,457,000		$ 10,946,000	$ 11,457,000
Ground lease liabilities		10,946,000	11,457,000		10,946,000	11,457,000
Measurement of lease liabilities related to operating leases					666,000	611,000
Operating lease expense					666,000	611,000	$ 508,000
Wellington Regional Medical Center | Palm Beach, Florida
Leases Disclosure [Line Items]
Lessee operating lease, existence of option to extend							true
Operating lease renewal term							5 years
Monthly lease rent receivable							$ 6,300,000
Percentage of annual rental increase on cumulative and compound basis							2.50%
Lease revenue					6,500,000	6,600,000	$ 5,500,000
Wellington Regional Medical Center | Base Rents | Palm Beach, Florida
Leases Disclosure [Line Items]
Lease revenue							3,000,000
Wellington Regional Medical Center | Bonus Rents | Palm Beach, Florida
Leases Disclosure [Line Items]
Lease revenue							2,500,000
Specialty Facility In Corpus Christi Texas | Corpus Christi, Texas
Leases Disclosure [Line Items]
Net of closing costs					3,900,000
Divestiture generated loss		232,000			232,000
Other operating expenses demolition costs					254,000,000	302,000,000	371,000,000
Specialty hospital located in Chicago, Illinois | Chicago, Illinois
Leases Disclosure [Line Items]
Lease revenue							1,600,000
Lease settlement and release agreement amount			1,250,000
Lease Demolition Cost					1,500,000
Other operating expenses demolition costs					1,100,000	332,000
Operating expenses including demolition costs					1,700,000	1,600,000
Operating expenses excluding demolition					529,000	1,300,000
Specialty Facility Evansville Indiana | Evansville, Indiana
Leases Disclosure [Line Items]
Operating expenses excluding depreciation and amortization expense					401,000	360,000	366,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health
Leases Disclosure [Line Items]
Fair market value of real estate assets received					83,300,000	83,600,000
Monthly lease rent receivable		$ 5,800,000	5,700,000	$ 5,800,000	$ 5,800,000	5,700,000
Lease revenue							$ 4,500,000
Term of lease		12 years			12 years		12 years
Number of term renewal options | Time		7			7
Lease renewal term		5 years			5 years
Lease payments expected					$ 5,500,000	5,500,000
Lease expiration date							Dec. 31, 2033
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Base Rents
Leases Disclosure [Line Items]
Lease revenue							$ 2,600,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Bonus Rents
Leases Disclosure [Line Items]
Lease revenue					0		1,900,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Southwest Healthcare System Inland Valley Campus
Leases Disclosure [Line Items]
Lease revenue							4,500,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Southwest Healthcare System Inland Valley Campus | Base Rents
Leases Disclosure [Line Items]
Lease revenue							2,600,000
Aiken Regional Medical Center and Canyon Creek Behavioral Health | Southwest Healthcare System Inland Valley Campus | Bonus Rents
Leases Disclosure [Line Items]
Lease revenue							1,900,000
Aiken Regional Medical Center
Leases Disclosure [Line Items]
Monthly lease rent receivable		$ 4,000,000	3,900,000	4,000,000	4,000,000	3,900,000
Canyon Creek Behavioral Health
Leases Disclosure [Line Items]
Monthly lease rent receivable		$ 1,800,000	1,800,000	$ 1,800,000	1,800,000	1,800,000
Universal Health Services, Inc
Leases Disclosure [Line Items]
Lease revenue	[1]				32,623,000	29,954,000	29,896,000
Number of term renewal options | Time								2
Interest income on financing leases - UHS facilities					5,458,000	5,474,000
Universal Health Services, Inc | Base Rents
Leases Disclosure [Line Items]
Lease revenue					26,173,000	24,485,000	21,498,000
Universal Health Services, Inc | Bonus Rents
Leases Disclosure [Line Items]
Lease revenue	[2]				$ 2,953,000	2,801,000	6,906,000
Universal Health Services, Inc | Wellington Regional Medical Center
Leases Disclosure [Line Items]
Percentage of annual rental increase on cumulative and compound basis					2.50%
Universal Health Services, Inc | Wellington Regional Medical Center | Palm Beach, Florida
Leases Disclosure [Line Items]
Operating lease renewal term		5 years			5 years
Monthly lease rent receivable							$ 6,500,000
Percentage of annual rental increase on cumulative and compound basis							2.50%
Lease revenue							$ 5,500,000
Universal Health Services, Inc | Wellington Regional Medical Center | Base Rents | Palm Beach, Florida
Leases Disclosure [Line Items]
Lease revenue							3,000,000
Universal Health Services, Inc | Wellington Regional Medical Center | Bonus Rents | Palm Beach, Florida
Leases Disclosure [Line Items]
Lease revenue							$ 2,500,000
Universal Health Services, Inc | Subsidiary
Leases Disclosure [Line Items]
Number of wholly-owned subsidiaries | Subsidiary				2			2
Financing receivable		$ 83,300,000	$ 83,600,000		$ 83,300,000	$ 83,600,000
Financing Arrangements
Leases Disclosure [Line Items]
Number of lease property | Lease							2
Asset Purchase and Sale Agreement | Universal Health Services, Inc | Subsidiary
Leases Disclosure [Line Items]
Cash received for sale of real estate asset				$ 4,100,000
Gain on sale of real estate assets					$ 68,400,000		$ 68,400,000
Asset Purchase and Sale Agreement | Universal Health Services, Inc | Subsidiary | Aiken Regional Medical Center and Canyon Creek Behavioral Health
Leases Disclosure [Line Items]
Fair market value of real estate assets received				83,700,000			83,700,000
Asset Purchase and Sale Agreement | Universal Health Services, Inc | Subsidiary | Inland Valley Campus of Southwest Healthcare System
Leases Disclosure [Line Items]
Fair market value of real estate asset sold							79,600,000
Cash received for sale of real estate asset							4,100,000
Asset Purchase and Sale Agreement | Universal Health Services, Inc | Subsidiary | Inland Valley Campus of Southwest Healthcare System | Wildomar, California
Leases Disclosure [Line Items]
Fair market value of real estate asset sold				79,600,000			79,600,000
Asset Purchase and Sale Agreement | Universal Health Services, Inc | Subsidiary | Aiken Regional Medical Center | Aiken, South Carolina
Leases Disclosure [Line Items]
Fair market value of real estate assets received				57,700,000			57,700,000
Asset Purchase and Sale Agreement | Universal Health Services, Inc | Subsidiary | Canyon Creek Behavioral Health | Temple, Texas
Leases Disclosure [Line Items]
Fair market value of real estate assets received				$ 26,000,000			$ 26,000,000
[1] Includes bonus rental on McAllen Medical Center, a UHS acute care hospital facility, o f $ 2,953 and $ 2,801 for the years ended December 31, 2023 and December 31, 2022, respectively, and includes bonus rental on three UHS acute care hospital facilities of $ 6,906 for the year ended December 31, 2021 . Includes bonus rental on McAllen Medical Center, a UHS acute care hospital facility of $ 2,953 and $ 2,801 for the years ended December 31, 2023 and 2022, respectively, and includes bonus rental on three UHS acute care hospital facilities of $ 6,906 for the year ended December 31, 2021. Please see disclosure below surrounding the December 31, 2021 asset purchase and sale transaction with UHS.

Lease Accounting - Components o

Lease Accounting - Components of the "Lease Revenue - UHS facilities" and "Lease Revenue - Non-related Parties" Captions (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Universal Health Services, Inc
Leases Disclosure [Line Items]
Lease revenue	[1]	$ 32,623	$ 29,954	$ 29,896
Universal Health Services, Inc | Base Rents
Leases Disclosure [Line Items]
Lease revenue		26,173	24,485	21,498
Universal Health Services, Inc | Bonus Rents
Leases Disclosure [Line Items]
Lease revenue	[2]	2,953	2,801	6,906
Universal Health Services, Inc | Tenant Reimbursements
Leases Disclosure [Line Items]
Lease revenue		3,497	2,668	1,492
Non-Related Parties
Leases Disclosure [Line Items]
Lease revenue		54,993	52,004	52,324
Non-Related Parties | Base Rents
Leases Disclosure [Line Items]
Lease revenue		42,159	40,533	41,880
Non-Related Parties | Tenant Reimbursements
Leases Disclosure [Line Items]
Lease revenue		$ 12,834	$ 11,471	$ 10,444
[1] Includes bonus rental on McAllen Medical Center, a UHS acute care hospital facility, o f $ 2,953 and $ 2,801 for the years ended December 31, 2023 and December 31, 2022, respectively, and includes bonus rental on three UHS acute care hospital facilities of $ 6,906 for the year ended December 31, 2021 . Includes bonus rental on McAllen Medical Center, a UHS acute care hospital facility of $ 2,953 and $ 2,801 for the years ended December 31, 2023 and 2022, respectively, and includes bonus rental on three UHS acute care hospital facilities of $ 6,906 for the year ended December 31, 2021. Please see disclosure below surrounding the December 31, 2021 asset purchase and sale transaction with UHS.

Lease Accounting - Components_2

Lease Accounting - Components of the "Lease Revenue - UHS facilities" and "Lease Revenue - Non-related Parties" Captions (Parenthetical) (Details) - Bonus Rents [Member] - McAllen Medical Center $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) Hospital	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Leases Disclosure [Line Items]
Lease revenue | $	$ 2,953	$ 2,801	$ 6,906
Number of facilities | Hospital	3

Schedule of Minimum Future Base

Schedule of Minimum Future Base Rents from Non-Cancelable Leases (Topic 842) (Detail) $ in Thousands	Dec. 31, 2023 USD ($)
Leases [Abstract]
2024	$ 76,221
2025	70,064
2026	63,358
2027	43,935
2028	36,586
Thereafter	151,894
Total minimum base rents	$ 442,058

Schedule of Supplemental Balanc

Schedule of Supplemental Balance Sheet Information Related to Leases (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Operating Leases
Right-of-use land assets, net	$ 10,946	$ 11,457
Ground lease liabilities, net	$ 10,946	$ 11,457
Weighted Average remaining lease term, years
Operating leases	56 years 3 months 18 days
Weighted Average discount rate
Operating leases	6.29%

Schedule of Maturities of lease

Schedule of Maturities of lease liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Leases [Abstract]
2024	$ 704
2025	704
2026	704
2027	704
2028	704
Later years	36,027
Total undiscounted lease payments	39,547
Less imputed interest	28,601
Ground lease liabilities, net	$ 10,946	$ 11,457

Debt and Financial Instrument_2

Debt and Financial Instruments - Additional Information (Detail)				1 Months Ended		3 Months Ended	12 Months Ended
	May 15, 2023	Jul. 02, 2021 USD ($)	Mar. 27, 2018 USD ($) Option	Mar. 31, 2020 USD ($) Derivative	Jan. 31, 2020 USD ($) Derivative	Sep. 30, 2019 USD ($) Derivative	Dec. 31, 2023 USD ($) Derivative	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Debt Instrument [Line Items]
Net borrowings on the line of credit							$ 28,500,000	$ 26,200,000	$ 35,700,000
Proceeds from lines of Credit							$ 28,500,000	26,200,000	35,700,000
Credit facility, Interest Rate Terms							orrowings under the Credit Agreement will bear interest at a rate equal to, at our option, at adjusted term SOFR for either one, three, or six months or the Base Rate, plus in either case, a specified margin depending on our total leverage ratio, as determined by the formula set forth in the Credit Agreement. The applicable margin after the first amendment ranges from 1.10% to 1.35% for adjusted term SOFR loans and 0.10% to 0.35% for Base Rate loans
Outstanding borrowings under revolving credit agreement							$ 326,600,000	298,100,000
Letters Of Credit Outstanding Amount							3,100,000	3,100,000
Available borrowing capacity							45,300,000	73,800,000
Compensating Balance Amount							0
Line of credit, fair value of borrowings outstanding							326,600,000	298,100,000
Average amounts outstanding under our revolving credit agreement							$ 309,300,000	$ 277,900,000	$ 253,500,000
Effective interest rate							4.80%	2.90%	2.20%
Interest Rate Swap
Debt Instrument [Line Items]
Notional amount							$ 25,000
Derivative interest rate cap, payment received or accrued from counterparties							$ 5,800,000
Derivative interest rate cap, offset due to counterparties								$ 1,400,000
Interest Rate Swap | Cash Flow Hedge
Debt Instrument [Line Items]
Number of interest rate cap agreements | Derivative							1
Derivative instruments, fixed rate							3.9495%
Expiration date of interest rate							Dec. 01, 2027
Interest Rate Swap Agreement One
Debt Instrument [Line Items]
Derivative interest rate cap, payment received or accrued from counterparties							$ 3,300,000
Interest Rate Swap Agreement One | Cash Flow Hedge
Debt Instrument [Line Items]
Number of interest rate cap agreements | Derivative				1
Derivative instruments, fixed rate				0.565%
Notional amount				$ 55,000,000
Expiration date of interest rate				Mar. 25, 2027
Interest Rate Swap Agreement Two
Debt Instrument [Line Items]
Derivative interest rate cap, payment received or accrued from counterparties							3,300,000
Interest Rate Swap Agreement Two | Cash Flow Hedge
Debt Instrument [Line Items]
Number of interest rate cap agreements | Derivative					1
Derivative instruments, fixed rate					1.4975%
Notional amount					$ 35,000,000
Expiration date of interest rate					Sep. 16, 2024
Interest Rate Swap Agreement Three | Cash Flow Hedge
Debt Instrument [Line Items]
Number of interest rate cap agreements | Derivative						1
Derivative instruments, fixed rate						1.144%
Notional amount						$ 50,000,000
Expiration date of interest rate						Sep. 16, 2024
Level 2
Debt Instrument [Line Items]
Mortgage debt							33,100,000	45,000,000
Mortgage loan fair value							31,200,000	43,200,000
Derivative interest rate cap, net payment received or accrued from counterparties								414,000
Level 2 | Interest Rate Swap
Debt Instrument [Line Items]
Liability derivatives, fair value							$ 7,300,000
Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate
Debt Instrument [Line Items]
Margin points added to the reference rate	0.10%
Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate | Interest Rate Swap | Cash Flow Hedge
Debt Instrument [Line Items]
Derivative instruments, fixed rate							3.9495%
Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate | Interest Rate Swap Agreement One | Cash Flow Hedge
Debt Instrument [Line Items]
Derivative instruments, fixed rate	0.505%
Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate | Interest Rate Swap Agreement Two | Cash Flow Hedge
Debt Instrument [Line Items]
Derivative instruments, fixed rate	1.41%
Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate | Interest Rate Swap Agreement Three | Cash Flow Hedge
Debt Instrument [Line Items]
Derivative instruments, fixed rate	1.064%
Credit Agreement
Debt Instrument [Line Items]
Outstanding borrowing		$ 350,000,000	$ 375,000,000
Net borrowings on the line of credit		350,000,000	$ 50,000,000
Aggregate borrowings under Credit Agreement							$ 78,400,000	67,000,000	$ 88,800,000
Aggregate repayments							$ 49,900,000	$ 40,800,000	$ 53,100,000
Unsecured revolving amended credit agreement terminated date			Jul. 02, 2025
Proceeds from lines of Credit		350,000,000	$ 50,000,000
Increase in borrowing capacity		$ 375,000,000
Number of additional six month extension options | Option			2
Credit Agreement | Swingline/Short-Term Loans
Debt Instrument [Line Items]
Outstanding borrowing			$ 30,000,000
Credit Agreement | Letters of Credit
Debt Instrument [Line Items]
Outstanding borrowing			$ 40,000,000
Revolving A Facility | Minimum
Debt Instrument [Line Items]
Facility fee payable on commitment			0.15%
Revolving A Facility | Minimum | Base Rate
Debt Instrument [Line Items]
Margin points added to the reference rate			10%
Revolving A Facility | Minimum | Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate
Debt Instrument [Line Items]
Margin points added to the reference rate			1.10%
Margin points added to the base rate			1%
Revolving A Facility | Minimum | Federal Funds Effective Rate
Debt Instrument [Line Items]
Margin points added to the base rate			0.50%
Revolving A Facility | Maximum
Debt Instrument [Line Items]
Facility fee payable on commitment			0.35%
Revolving A Facility | Maximum | Base Rate
Debt Instrument [Line Items]
Margin points added to the reference rate			0.35%
Revolving A Facility | Maximum | Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate
Debt Instrument [Line Items]
Margin points added to the reference rate			1.35%
Revolving B Facility | Base Rate
Debt Instrument [Line Items]
Margin points added to the reference rate							0.20%
Revolving B Facility | Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate
Debt Instrument [Line Items]
Margin points added to the reference rate							1.20%
Revolving B Facility | Federal Funds Effective Rate
Debt Instrument [Line Items]
Margin points added to the reference rate							0.20%

Summary of Required Compliance

Summary of Required Compliance Ratios in Connection with Terms of Credit Agreements (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Covenant, Tangible net worth	$ 125,000
Tangible net worth	$ 191,824	$ 219,654
Total leverage	44.50%	42.90%
Secured leverage	4.10%	5.60%
Unencumbered leverage	44.20%	41.80%
Fixed charge coverage	3.10%	4.30%
Maximum
Debt Instrument [Line Items]
Covenant, Total leverage	60%
Covenant, Secured leverage	30%
Covenant, Unencumbered leverage	60%
Minimum
Debt Instrument [Line Items]
Covenant, Fixed charge coverage	1.50%

Summary of Outstanding Mortgage

Summary of Outstanding Mortgages, Excluding Net Debt Premium (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2023		Dec. 31, 2022
Debt Instrument [Line Items]
Total mortgage notes payable, non-recourse to us, net		$ 32,863		$ 44,725
Nonrecourse
Debt Instrument [Line Items]
Outstanding Balance		33,062	[1]	44,953
Less net financing fees		(199)	[1]	(268)
Plus net debt premium				40
Total mortgage notes payable, non-recourse to us, net		$ 32,863	[1]	44,725
Desert Valley Medical Center Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Interest Rate	[2]	3.62%
Maturity Date	[2]	2023-01
Outstanding Balance	[2]			4,194
2704 North Tenaya Way Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Interest Rate	[3]	4.95%
Maturity Date	[3]	2023-11
Outstanding Balance	[3]			6,252
Summerlin Hospital Medical Office Building III Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Interest Rate	[4]	4.03%
Maturity Date	[4]	2024-04
Outstanding Balance	[4]	$ 12,301	[1]	12,558
Tuscan Professional Building Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Interest Rate		5.56%
Maturity Date		2025-06
Outstanding Balance		$ 1,060	[1]	1,719
Phoenix Children East Valley Care Center Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Interest Rate		3.95%
Maturity Date		2030-01
Outstanding Balance		$ 7,930	[1]	8,203
Rosenberg Children's Medical Plaza Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Interest Rate		4.42%
Maturity Date		2033-09
Outstanding Balance		$ 11,771	[1]	$ 12,027
[1] All mortgage loans require monthly principal payments through maturity and either fully amortize or include a balloon principal payment upon maturity. This $ 4.2 million fixed rate mortgage loan was fully repaid on January 3, 2023, utilizing borrowings under our Credit Agreement. This $ 6.3 million fixed rate mortgage loan was fully repaid on November 1, 2023, utilizing borrowings under our Credit Agreement. This loan is scheduled to mature within the next twelve months, at which time we will either refinance pursuant to a new mortgage loan or repay the mortgage balance in full utilizing borrowings under our Credit Agreement.

Summary of Outstanding Mortga_2

Summary of Outstanding Mortgages, Excluding Net Debt Premium (Parenthetical) (Detail) - USD ($) $ in Millions	Nov. 01, 2023	Jan. 03, 2023
700 Shadow Lane and Goldring MOBs Fixed Rate Mortgage Loan | Nonrecourse
Debt Instrument [Line Items]
Repayment of mortgage loan	$ 6.3	$ 4.2

Aggregate Consolidated Schedule

Aggregate Consolidated Scheduled Debt Repayment (Detail) $ in Thousands	Dec. 31, 2023 USD ($)
Debt Disclosure [Abstract]
2024	$ 13,550
2025	327,539	[1]
2026	601
2027	626
2028	653
Later	16,693
Total	$ 359,662
[1] Includes assumed repayment of $ 326.6 million of outstanding borrowings under the terms of our $ 375 million revolving credit agreement scheduled to mature in July, 2025 .

Aggregate Consolidated Schedu_2

Aggregate Consolidated Scheduled Debt Repayment (Parenthetical) (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Schedule Of Equity Method Investments [Line Items]
Line of credit borrowings	$ 326,600,000	$ 298,100,000
New Revolving Credit Facility Agreement
Schedule Of Equity Method Investments [Line Items]
Outstanding borrowing	$ 375,000,000
Maturity date	Jul. 31, 2025

Dividends and Equity Issuance_2

Dividends and Equity Issuance Program - Additional Information (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Dividends and Equity Issuance [Line Items]
Declared and paid dividends, per share	$ 2.88	$ 2.84	$ 2.8
Ordinary income per share	1.73	2.24	2.51
Capital gain per share	$ 1.15	$ 0.60	0.16
Capital gain
Dividends and Equity Issuance [Line Items]
Capital gain per share			0.13
Unrecaptured Section 1250 gain dividends per share			$ 0.04

Incentive Plans - Additional In

Incentive Plans - Additional Information (Detail) - Incentive Plan 2007 - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Equity Incentive Plan [Line Items]
Number of shares authorized for issuance	175,000
Shares issued, net of cancellation	159,373
Number of shares vested	127,205
Number of shares remaining for issuance	15,627
Restricted shares issued, net of cancellation	17,104	15,064	10,165
Restricted shares issued, weighted average grant price	$ 48.48	$ 52.3	$ 71.69
Restricted shares of beneficial interest, net of cancellations, issued, value	$ 829,000	$ 788,000	$ 729,000
Restricted shares, Vesting Period		2024-06	2023-06
Compensation expense	780,000	$ 780,000	$ 947,000
Compensation expense remained to be recognized in future	$ 762,000
Compensation expense not yet recognized, period of recognition	1 year 2 months 12 days
Tranche One
Equity Incentive Plan [Line Items]
Restricted shares, Vesting Period	2025-06

Summarized Financial Informat_3

Summarized Financial Information of Equity Affiliates - Additional Information (Detail) - Property	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2021
Grayson Properties
Schedule Of Equity Method Investments [Line Items]
Minority ownership interest held by a third-party		5%
Ownership percentage upon completion of the minority ownership purchase	100%	100%
Limited Liability Companies | Medical office buildings
Schedule Of Equity Method Investments [Line Items]
Number of real estate investments	4
Minimum
Schedule Of Equity Method Investments [Line Items]
Number of days for Non-Offering Member either to purchase or sell its entire ownership interest to or from Offering Member	60 days
Maximum
Schedule Of Equity Method Investments [Line Items]
Number of days for Non-Offering Member either to purchase or sell its entire ownership interest to or from Offering Member	90 days
4 Unconsolidated Limited Liability Companies / Limited Partner | Minimum
Schedule Of Equity Method Investments [Line Items]
Non-controlling equity interest, ownership percentage	33%
4 Unconsolidated Limited Liability Companies / Limited Partner | Maximum
Schedule Of Equity Method Investments [Line Items]
Non-controlling equity interest, ownership percentage	95%

Limited Liability Companies Acc

Limited Liability Companies Accounted for Under Equity Method (Detail)	12 Months Ended
	Dec. 31, 2023
Suburban Properties
Schedule Of Equity Method Investments [Line Items]
Ownership	33%
Property Owned by LLC/LP	St. Matthews Medical Plaza II
Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Ownership	74%	[1],[2]
Property Owned by LLC/LP	Mid Coast Hospital MOB	[1],[2]
FTX MOB Phase II limited partnership
Schedule Of Equity Method Investments [Line Items]
Ownership	95%	[3]
Property Owned by LLC/LP	Forney Medical Plaza II	[3]
Grayson Properties Two L P
Schedule Of Equity Method Investments [Line Items]
Ownership	95%	[4],[5]
Property Owned by LLC/LP	Texoma Medical Plaza II	[4],[5]
[1] This LLC has a third-party term loan of $ 8.5 million, which is non-recourse to us, outstanding as of December 31, 2023. We are the lessee with a third party on a ground lease for land. During the first quarter of 2021, this LP paid off its $ 4.7 million mortgage loan, upon maturity, utilizing pro rata equity contributions from the limited partners as well as a $ 3.5 million member loan from us to the LP which was funded utilizing borr owings from our revolving credit agreement. During the first quarter of 2023, the LP repaid $ 175,000 of the member loan and the remaining $ 3.3 million member loan balance was converted to an equity investment in the LP. This LP constructed, owns and operates the Texoma Medical Plaza II, on which construction substantially completed in December 2020. The MOB is located in Denison, Texas, on the campus of a hospital owned and operated by a wholly-owned subsidiary of UHS. We have committed to invest up to $ 5.2 million in eq uity and debt financing, $ 2.2 million of which has been funded as of December 31, 2023. This LP entered into a third-party construction loan commitment, which is non-recourse to us, which has an outstanding balance of $ 12.8 million as of December 31, 2023. Monthly principal and interest payments on this loan commenced on January 1, 2023. During the first quarter of 2024, $ 5.7 million of the third-party construction loan was repa id utilizing pro rata equity contributions from the partners. The third-party partner's share of the pro rata equity contributions was partially funded with a six-month, $ 128,000 partner loan from us. Our share of the pro rata equity contributions, as well as the third-party partner loan, were funded utilizing borrowings from our revolving credit agreement. As a result of the repayment of a portion of the construction loan, an associated $ 3.1 million letter of credit was terminated. We are the lessee with a UHS-related party for the land related to this property.

Limited Liability Companies A_2

Limited Liability Companies Accounted for Under Equity Method (Parenthetical) (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2021	Mar. 31, 2024	Dec. 31, 2023
Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Third-party term loan				$ 8,500,000
FTX MOB Phase II limited partnership
Schedule Of Equity Method Investments [Line Items]
Repayment of loan	$ 175,000	$ 4,700,000
Conversion of Loan to Equity Method Investment	$ 3,300,000
Member loan used to repay mortgage loan		$ 3,500,000
Grayson Properties II LP
Schedule Of Equity Method Investments [Line Items]
Member loan used to repay mortgage loan				128,000
Letters of Credit Terminated Amount				3,100,000
Construction loan outstanding balance				12,800,000
Grayson Properties II LP | Denison Texas
Schedule Of Equity Method Investments [Line Items]
Commitment to investment				2,200,000
Grayson Properties II LP | Scenario Forecast
Schedule Of Equity Method Investments [Line Items]
Construction loan			$ 5,700,000
Grayson Properties II LP | Maximum | Denison Texas
Schedule Of Equity Method Investments [Line Items]
Commitment to investment				$ 5,200,000

Combined Statements of Income f

Combined Statements of Income for LLCs/LPs Accounted Under Equity Method (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Schedule Of Equity Method Investments [Line Items]
Revenues	$ 95,575	$ 90,625	$ 84,190
Net income	15,400	21,102	109,166
Our share of net income	1,207	1,191	1,796
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Our share of net income	1,207	1,191	1,796
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Revenues	8,505	8,204	10,575
Operating expenses	3,351	3,177	4,093
Depreciation and amortization	1,873	1,853	2,198
Interest, net	825	1,061	1,721
Net income	$ 2,456	$ 2,113	$ 2,563

Combined Balance Sheets for LLC

Combined Balance Sheets for LLCs/LPs Accounted Under Equity Method (Detail) - USD ($) $ in Thousands		Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Schedule Of Equity Method Investments [Line Items]
Total Assets		$ 596,369	$ 607,540
Equity		200,934	229,101	$ 235,327	$ 159,005
Total Liabilities and Equity		596,369	607,540
Investments in LLCs before amounts included in accrued expenses and other liabilities		9,102	9,282
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Our share of equity in LLCs, net		7,373	7,573
Equity Method Investment, Nonconsolidated Investee or Group of Investees
Schedule Of Equity Method Investments [Line Items]
Net property, including construction in progress		28,488	29,573
Other assets	[1]	4,667	4,334
Total Assets		33,155	33,907
Other liabilities	[1]	2,074	2,338
Mortgage notes payable, non-recourse to us		21,206	21,802
Advances payable to us	[2]	0	3,500
Equity		9,875	6,267
Total Liabilities and Equity		33,155	33,907
Investments in LLCs before amounts included in accrued expenses and other liabilities		9,102	9,282
Amounts included in accrued expenses and other liabilities		$ (1,729)	$ (1,709)
[1] Other assets and other liabilities as of December 31, 2023 and 2022, include approximately $ 651,000 and $ 654,000 , respectively, of right-of-use land assets and right-of-use land liabilities related to ground leases whereby the LLC/LP is the lessee, with third parties, including subsidiaries of UHS. 7.25% member loan to FTX MOB Phase II, LP had a maturity date of March 1, 2023 . Upon the maturity date, the LP repaid $ 175,000 of the member loan to us and the remaining balance of $ 3.3 million was converted to an equity contribution by us.

Combined Balance Sheets for L_2

Combined Balance Sheets for LLCs/LPs Accounted Under Equity Method (Parenthetical) (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Schedule Of Equity Method Investments [Line Items]
Right-of-use land assets	$ 10,946,000	$ 11,457,000
Right-of-use land liabilities	10,946,000	11,457,000
Limited Liability Companies
Schedule Of Equity Method Investments [Line Items]
Right-of-use land assets	651,000	654,000
Right-of-use land liabilities	$ 651,000	$ 654,000
FTX MOB Phase II limited partnership
Schedule Of Equity Method Investments [Line Items]
Maturity date	Mar. 01, 2023
Repayment of loan	$ 175,000,000
Conversion of loan to equity method investment	$ 3,300,000

Aggregate Principal Amounts Due

Aggregate Principal Amounts Due on Mortgage Notes Payable by Unconsolidated LLCs, Accounted Under Equity Method (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2023	Dec. 31, 2022
Schedule Of Equity Method Investments [Line Items]
2024		$ 13,550
2025	[1]	327,539
2026		601
2027		626
2028		653
2029 and thereafter		16,693
Total		359,662
Equity Method Investments
Schedule Of Equity Method Investments [Line Items]
2024		613
2025		310
2026		12,704
2027		293
2028		301
2029 and thereafter		6,985
Total		21,206
Mortgage Loan Balance	[2]	21,206	$ 21,802
Equity Method Investments | Brunswick Associates
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[2]	$ 8,453	8,727
Maturity Date	[2]	2030-12
Equity Method Investments | Grayson Properties II LP
Schedule Of Equity Method Investments [Line Items]
Mortgage Loan Balance	[2],[3]	$ 12,753	$ 13,075
Maturity Date	[2],[3]	2025-06
[1] Includes assumed repayment of $ 326.6 million of outstanding borrowings under the terms of our $ 375 million revolving credit agreement scheduled to mature in July, 2025 . All mortgage loans require monthly principal payments through maturity and include a balloon principal payment upon maturity. This construction loan required interest on the outstanding principal balance to be paid on a monthly basis through December 1, 2022. On January 1, 2023, monthly principal and interest payments on the loan commenced. During the first quarter of 2024, $ 5.7 million of the third-party construction loan was repa id utilizing pro rata equity contributions from the partners, as discussed above. As a result of the repayment of a portion of the construction loan, an associated $ 3.1 million letter of credit was terminated.

Segment Reporting - Additional

Segment Reporting - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2023 Segment
Segment Reporting [Abstract]
Number of reportable segments	1

Schedule III Real Estate and Ac

Schedule III Real Estate and Accumulated Depreciation (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2023		Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[2]	$ 33,062
Initial Cost, Land	[2]	55,134
Initial Cost, Building & Improvements	[2]	531,613
Adjustments to Basis	[2],[3]	109,913
Land	[2]	56,870
Buildings and Improvements	[2]	639,790
CIP	[2]	9,584
Total		706,244	[2]	$ 697,969	$ 663,733	$ 660,449
Accumulated Depreciation		262,449	[2]	$ 248,772
McAllen Medical Center McAllen, Texas
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	0
Initial Cost, Land		4,720
Initial Cost, Building & Improvements		31,442
Adjustments to Basis	[3]	10,189
Land		6,281
Buildings and Improvements		40,070
Total		46,351
Accumulated Depreciation		$ 32,892
Date of Completion of Construction, Acquisition or Significant Improvement		1994
Date Acquired		1986
Average Depreciable Life		42 years
Wellington Regional Medical Center West Palm Beach, Florida
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		1,190
Initial Cost, Building & Improvements		14,652
Adjustments to Basis	[3]	17,370
Land		1,663
Buildings and Improvements		31,549
Total		33,212
Accumulated Depreciation		$ 24,410
Date of Completion of Construction, Acquisition or Significant Improvement		2006
Date Acquired		1986
Average Depreciable Life		42 years
Evansville Facility Evansville Indiana
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		500
Initial Cost, Building & Improvements		6,945
Adjustments to Basis	[3]	1,062
Land		500
Buildings and Improvements		8,007
Total		8,507
Accumulated Depreciation		$ 6,897
Date of Completion of Construction, Acquisition or Significant Improvement		1993
Date Acquired		1989
Average Depreciable Life		40 years
4058 W. Melrose Facility Central Chicago Illinois
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		158
Initial Cost, Building & Improvements		6,404
Adjustments to Basis	[3]	(6,404)
Land		158
Buildings and Improvements		0
Total		158
Accumulated Depreciation		$ 0
Date of Completion of Construction, Acquisition or Significant Improvement		1993
Date Acquired		1986
Average Depreciable Life		25 years
Family Doctor Medical Office Building Shreveport Louisiana
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		54
Initial Cost, Building & Improvements		1,526
Adjustments to Basis	[3]	549
Land		54
Buildings and Improvements		2,075
Total		2,129
Accumulated Depreciation		$ 1,350
Date of Completion of Construction, Acquisition or Significant Improvement		1991
Date Acquired		1995
Average Depreciable Life		45 years
Professional Buildings at Kings Crossing Texas
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[4]	$ 0
Initial Cost, Land	[4]	439
Initial Cost, Building & Improvements	[4]	1,837
Adjustments to Basis	[3],[4]	(297)
Land	[4]	439
Buildings and Improvements	[4]	1,540
Total	[4]	1,979
Accumulated Depreciation	[4]	$ 682
Date of Completion of Construction, Acquisition or Significant Improvement	[4]	1995
Date Acquired	[4]	1995
Average Depreciable Life	[4]	45 years
Chesterbrook Academy Audubon, Pennsylvania
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		307
Initial Cost, Building & Improvements		996
Adjustments to Basis	[3]	0
Land		307
Buildings and Improvements		996
Total		1,303
Accumulated Depreciation		$ 609
Date of Completion of Construction, Acquisition or Significant Improvement		1996
Date Acquired		1996
Average Depreciable Life		45 years
Chesterbrook Academy New Britain, Pennsylvania
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		250
Initial Cost, Building & Improvements		744
Adjustments to Basis	[3]	0
Land		250
Buildings and Improvements		744
Total		994
Accumulated Depreciation		$ 463
Date of Completion of Construction, Acquisition or Significant Improvement		1991
Date Acquired		1996
Average Depreciable Life		45 years
Chesterbrook Academy Uwchlan, Pennsylvania
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		180
Initial Cost, Building & Improvements		815
Adjustments to Basis	[3]	0
Land		180
Buildings and Improvements		815
Total		995
Accumulated Depreciation		$ 496
Date of Completion of Construction, Acquisition or Significant Improvement		1992
Date Acquired		1996
Average Depreciable Life		45 years
Chesterbrook Academy Newtown, Pennsylvania
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		195
Initial Cost, Building & Improvements		749
Adjustments to Basis	[3]	0
Land		195
Buildings and Improvements		749
Total		944
Accumulated Depreciation		$ 464
Date of Completion of Construction, Acquisition or Significant Improvement		1992
Date Acquired		1996
Average Depreciable Life		45 years
The Southern Crescent Center I
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[5]	$ 0
Initial Cost, Land	[5]	1,130
Initial Cost, Building & Improvements	[5]	5,092
Adjustments to Basis	[3],[5]	(1,991)
Land	[5]	1,130
Buildings and Improvements	[5]	3,101
CIP	[5]	13
Total	[5]	4,244
Accumulated Depreciation	[5]	$ 2,871
Date of Completion of Construction, Acquisition or Significant Improvement	[5]	1994
Date Acquired	[5]	1996
Average Depreciable Life	[5]	45 years
Southern Crescent Center I I Riverdale Georgia [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[5]	$ 0
Initial Cost, Land	[5]	0
Initial Cost, Building & Improvements	[5]	0
Adjustments to Basis	[3],[5]	5,389
Land	[5]	806
Buildings and Improvements	[5]	4,583
CIP	[5]	13
Total	[5]	5,402
Accumulated Depreciation	[5]	$ 3,665
Date of Completion of Construction, Acquisition or Significant Improvement	[5]	2000
Date Acquired	[5]	1998
Average Depreciable Life	[5]	35 years
Cypresswood Professional Center Spring,Texas [Member]
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[6]	$ 0
Initial Cost, Land	[6]	573
Initial Cost, Building & Improvements	[6]	3,842
Adjustments to Basis	[3],[6]	(2,122)
Land	[6]	573
Buildings and Improvements	[6]	1,720
Total	[6]	2,293
Accumulated Depreciation	[6]	$ 530
Date of Completion of Construction, Acquisition or Significant Improvement	[6]	1997
Date Acquired	[6]	1997
Average Depreciable Life	[6]	35 years
701 South Tonopah Building Las Vegas, Nevada
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[7]	$ 0
Initial Cost, Land	[7]	0
Initial Cost, Building & Improvements	[7]	1,579
Adjustments to Basis	[3],[7]	68
Land	[7]	0
Buildings and Improvements	[7]	1,647
Total	[7]	1,647
Accumulated Depreciation	[7]	$ 1,600
Date of Completion of Construction, Acquisition or Significant Improvement	[7]	1999
Date Acquired	[7]	1999
Average Depreciable Life	[7]	25 years
Danbury Medical Plaza Danbury, Connecticut
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		1,151
Initial Cost, Building & Improvements		5,176
Adjustments to Basis	[3]	1,576
Land		1,151
Buildings and Improvements		6,752
Total		7,903
Accumulated Depreciation		$ 4,979
Date of Completion of Construction, Acquisition or Significant Improvement		2000
Date Acquired		2000
Average Depreciable Life		30 years
Corpus Christi Facility Corpus Christi, Texas
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		1,104
Initial Cost, Building & Improvements		5,508
Adjustments to Basis	[3]	6,612
Land		0
Buildings and Improvements		0
Total		0
Accumulated Depreciation		$ 0
Date of Completion of Construction, Acquisition or Significant Improvement		2008
Date Acquired		2008
Average Depreciable Life		35 years
Apache Junction Medical Plaza Apache Junction, AZ
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		240
Initial Cost, Building & Improvements		3,590
Adjustments to Basis	[3]	1,414
Land		240
Buildings and Improvements		5,004
CIP		5
Total		5,249
Accumulated Depreciation		$ 2,896
Date of Completion of Construction, Acquisition or Significant Improvement		2004
Date Acquired		2004
Average Depreciable Life		30 years
BRB Medical Office Building Kingwood, Texas
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		430
Initial Cost, Building & Improvements		8,970
Adjustments to Basis	[3]	1,404
Land		430
Buildings and Improvements		10,374
Total		10,804
Accumulated Depreciation		$ 3,766
Date of Completion of Construction, Acquisition or Significant Improvement		2010
Date Acquired		2010
Average Depreciable Life		37 years
Centennial Hills Medical Office Building Las Vegas, NV
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[7]	$ 0
Initial Cost, Land	[7]	0
Initial Cost, Building & Improvements	[7]	19,890
Adjustments to Basis	[3],[7]	3,606
Land	[7]	0
Buildings and Improvements	[7]	23,496
CIP	[7]	226
Total	[7]	23,722
Accumulated Depreciation	[7]	$ 10,191
Date of Completion of Construction, Acquisition or Significant Improvement	[7]	2006
Date Acquired	[7]	2006
Average Depreciable Life	[7]	34 years
Desert Springs Medical Plaza Las Vegas, NV
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		1,200
Initial Cost, Building & Improvements		9,560
Adjustments to Basis	[3]	2,782
Land		1,200
Buildings and Improvements		12,342
Total		13,542
Accumulated Depreciation		$ 6,127
Date of Completion of Construction, Acquisition or Significant Improvement		1998
Date Acquired		1998
Average Depreciable Life		30 years
700 Shadow Lane & Goldring MOBs Las Vegas, NV
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		400
Initial Cost, Building & Improvements		11,300
Adjustments to Basis	[3]	5,766
Land		400
Buildings and Improvements		17,066
CIP		889
Total		18,355
Accumulated Depreciation		$ 8,549
Date of Completion of Construction, Acquisition or Significant Improvement		2003
Date Acquired		2003
Average Depreciable Life		30 years
Spring Valley Hospital MOB II Las Vegas, NV
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[7]	$ 0
Initial Cost, Land	[7]	0
Initial Cost, Building & Improvements	[7]	9,800
Adjustments to Basis	[3],[7]	2,162
Land	[7]	0
Buildings and Improvements	[7]	11,962
CIP	[7]	289
Total	[7]	12,251
Accumulated Depreciation	[7]	$ 5,009
Date of Completion of Construction, Acquisition or Significant Improvement	[7]	2006
Date Acquired	[7]	2006
Average Depreciable Life	[7]	34 years
Spring Valley Hospital MOB I Las Vegas, NV
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[7]	$ 0
Initial Cost, Land	[7]	0
Initial Cost, Building & Improvements	[7]	9,500
Adjustments to Basis	[3],[7]	2,441
Land	[7]	0
Buildings and Improvements	[7]	11,941
CIP	[7]	79
Total	[7]	12,020
Accumulated Depreciation	[7]	$ 5,136
Date of Completion of Construction, Acquisition or Significant Improvement	[7]	2004
Date Acquired	[7]	2004
Average Depreciable Life	[7]	35 years
Summerlin Hospital MOB I Las Vegas, NV
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		460
Initial Cost, Building & Improvements		15,440
Adjustments to Basis	[3]	2,226
Land		460
Buildings and Improvements		17,666
CIP		1,530
Total		19,656
Accumulated Depreciation		$ 8,498
Date of Completion of Construction, Acquisition or Significant Improvement		1999
Date Acquired		1999
Average Depreciable Life		30 years
Summerlin Hospital MOB II Las Vegas, NV
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		370
Initial Cost, Building & Improvements		16,830
Adjustments to Basis	[3]	2,844
Land		370
Buildings and Improvements		19,674
CIP		864
Total		20,908
Accumulated Depreciation		$ 8,833
Date of Completion of Construction, Acquisition or Significant Improvement		2000
Date Acquired		2000
Average Depreciable Life		30 years
Summerlin Hospital MOB III Las Vegas, NV
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[7]	$ 12,301
Initial Cost, Land	[7]	0
Initial Cost, Building & Improvements	[7]	14,900
Adjustments to Basis	[3],[7]	3,500
Land	[7]	0
Buildings and Improvements	[7]	18,400
CIP	[7]	22
Total	[7]	18,422
Accumulated Depreciation	[7]	$ 6,761
Date of Completion of Construction, Acquisition or Significant Improvement	[7]	2009
Date Acquired	[7]	2009
Average Depreciable Life	[7]	36 years
Emory at Dunwoody Building Dunwoody, GA
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		782
Initial Cost, Building & Improvements		3,455
Adjustments to Basis	[3]	0
Land		782
Buildings and Improvements		3,455
Total		4,237
Accumulated Depreciation		$ 1,528
Date of Completion of Construction, Acquisition or Significant Improvement		2011
Date Acquired		2011
Average Depreciable Life		35 years
Forney Medical Plaza Forney, TX
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		910
Initial Cost, Building & Improvements		11,960
Adjustments to Basis	[3]	1,126
Land		910
Buildings and Improvements		13,086
Total		13,996
Accumulated Depreciation		$ 5,368
Date of Completion of Construction, Acquisition or Significant Improvement		2011
Date Acquired		2011
Average Depreciable Life		35 years
Lake Pointe Medical Arts Building Rowlett, TX
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		1,100
Initial Cost, Building & Improvements		9,000
Adjustments to Basis	[3]	1,058
Land		1,100
Buildings and Improvements		10,058
Total		11,158
Accumulated Depreciation		$ 3,950
Date of Completion of Construction, Acquisition or Significant Improvement		2011
Date Acquired		2011
Average Depreciable Life		35 years
Tuscan Professional Building Irving, TX
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 1,060
Initial Cost, Land		1,100
Initial Cost, Building & Improvements		12,525
Adjustments to Basis	[3]	3,301
Land		1,100
Buildings and Improvements		15,826
CIP		9
Total		16,935
Accumulated Depreciation		$ 6,611
Date of Completion of Construction, Acquisition or Significant Improvement		2011
Date Acquired		2011
Average Depreciable Life		35 years
PeaceHealth Medical Clinic Bellingham, WA
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		1,900
Initial Cost, Building & Improvements		24,910
Adjustments to Basis	[3]	921
Land		1,900
Buildings and Improvements		25,831
Total		27,731
Accumulated Depreciation		$ 9,905
Date of Completion of Construction, Acquisition or Significant Improvement		2012
Date Acquired		2012
Average Depreciable Life		35 years
Northwest Texas Professional Office Tower Amarillo TX
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[7]	$ 0
Initial Cost, Land	[7]	0
Initial Cost, Building & Improvements	[7]	7,180
Adjustments to Basis	[3],[7]	1,526
Land	[7]	0
Buildings and Improvements	[7]	8,706
Total	[7]	8,706
Accumulated Depreciation	[7]	$ 3,157
Date of Completion of Construction, Acquisition or Significant Improvement	[7]	2012
Date Acquired	[7]	2012
Average Depreciable Life	[7]	35 years
Ward Eagle Office Village Farmington Hills MI
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		220
Initial Cost, Building & Improvements		3,220
Adjustments to Basis	[3]	200
Land		220
Buildings and Improvements		3,420
Total		3,640
Accumulated Depreciation		$ 1,260
Date of Completion of Construction, Acquisition or Significant Improvement		2013
Date Acquired		2013
Average Depreciable Life		35 years
5004 Poole Road Medical Office Building Denison, TX
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		96
Initial Cost, Building & Improvements		529
Adjustments to Basis	[3]	0
Land		96
Buildings and Improvements		529
Total		625
Accumulated Depreciation		$ 185
Date of Completion of Construction, Acquisition or Significant Improvement		2013
Date Acquired		2013
Average Depreciable Life		35 years
Desert Valley Medical Center Phoenix AZ
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		2,280
Initial Cost, Building & Improvements		4,624
Adjustments to Basis	[3]	1,408
Land		2,280
Buildings and Improvements		6,032
CIP		11
Total		8,323
Accumulated Depreciation		$ 2,593
Date of Completion of Construction, Acquisition or Significant Improvement		1996
Date Acquired		1996
Average Depreciable Life		30 years
Hanover Emergency Center Mechanicsville, VA
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		1,300
Initial Cost, Building & Improvements		6,224
Adjustments to Basis	[3]	0
Land		1,300
Buildings and Improvements		6,224
Total		7,524
Accumulated Depreciation		$ 1,953
Date of Completion of Construction, Acquisition or Significant Improvement		2014
Date Acquired		2014
Average Depreciable Life		35 years
Haas Medical Office Park Ottumwa, IA
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[8]	$ 0
Initial Cost, Land	[8]	0
Initial Cost, Building & Improvements	[8]	3,571
Adjustments to Basis	[3],[8]	0
Land	[8]	0
Buildings and Improvements	[8]	3,571
Total	[8]	3,571
Accumulated Depreciation	[8]	$ 1,064
Date of Completion of Construction, Acquisition or Significant Improvement	[8]	2015
Date Acquired	[8]	2015
Average Depreciable Life	[8]	35 years
South Texas ER at Mission, Mission, TX
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		1,441
Initial Cost, Building & Improvements		4,696
Adjustments to Basis	[3]	0
Land		1,441
Buildings and Improvements		4,696
Total		6,137
Accumulated Depreciation		$ 1,404
Date of Completion of Construction, Acquisition or Significant Improvement		2015
Date Acquired		2015
Average Depreciable Life		35 years
3811 E. Bell Phoenix, AZ
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		930
Initial Cost, Building & Improvements		6,929
Adjustments to Basis	[3]	2,397
Land		930
Buildings and Improvements		9,326
CIP		263
Total		10,519
Accumulated Depreciation		$ 3,969
Date of Completion of Construction, Acquisition or Significant Improvement		2010
Date Acquired		2010
Average Depreciable Life		30 years
Northwest Medical Center at Sugar Creek, Bentonville, AR
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		1,100
Initial Cost, Building & Improvements		2,870
Adjustments to Basis	[3]	140
Land		1,100
Buildings and Improvements		3,010
Total		4,110
Accumulated Depreciation		$ 979
Date of Completion of Construction, Acquisition or Significant Improvement		2014
Date Acquired		2014
Average Depreciable Life		35 years
Rosenberg Children's Medical Plaza, Phoenix, AZ
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[8]	$ 11,771
Initial Cost, Land	[8]	0
Initial Cost, Building & Improvements	[8]	23,302
Adjustments to Basis	[3],[8]	158
Land	[8]	0
Buildings and Improvements	[8]	23,460
Total	[8]	23,460
Accumulated Depreciation	[8]	$ 7,453
Date of Completion of Construction, Acquisition or Significant Improvement	[8]	2001
Date Acquired	[8]	2001
Average Depreciable Life	[8]	35 years
Phoenix Children's East Valley Care Center, Phoenix, AZ
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 7,930
Initial Cost, Land		1,050
Initial Cost, Building & Improvements		10,900
Adjustments to Basis	[3]	0
Land		1,050
Buildings and Improvements		10,900
Total		11,950
Accumulated Depreciation		$ 3,446
Date of Completion of Construction, Acquisition or Significant Improvement		2006
Date Acquired		2006
Average Depreciable Life		35 years
Palmdale Medical Plaza, Palmdale, CA
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[7]	$ 0
Initial Cost, Land	[7]	0
Initial Cost, Building & Improvements	[7]	10,555
Adjustments to Basis	[3],[7]	1,846
Land	[7]	0
Buildings and Improvements	[7]	12,401
CIP	[7]	836
Total	[7]	13,237
Accumulated Depreciation	[7]	$ 4,430
Date of Completion of Construction, Acquisition or Significant Improvement	[7]	2008
Date Acquired	[7]	2008
Average Depreciable Life	[7]	34 years
Piedmont-Roswell Physician Center Sandy Springs, GA
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		2,338
Initial Cost, Building & Improvements		2,128
Adjustments to Basis	[3]	0
Land		2,338
Buildings and Improvements		2,128
Total		4,466
Accumulated Depreciation		$ 798
Date of Completion of Construction, Acquisition or Significant Improvement		2015
Date Acquired		2015
Average Depreciable Life		30 years
Piedmont-Vinings Physician Center Vinings, GA
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		1,348
Initial Cost, Building & Improvements		2,418
Adjustments to Basis	[3]	0
Land		1,348
Buildings and Improvements		2,418
Total		3,766
Accumulated Depreciation		$ 876
Date of Completion of Construction, Acquisition or Significant Improvement		2015
Date Acquired		2015
Average Depreciable Life		30 years
Santa Fe Professional Plaza Scottsdale, AZ
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		1,090
Initial Cost, Building & Improvements		1,960
Adjustments to Basis	[3]	672
Land		1,090
Buildings and Improvements		2,632
Total		3,722
Accumulated Depreciation		$ 1,166
Date of Completion of Construction, Acquisition or Significant Improvement		1999
Date Acquired		1999
Average Depreciable Life		30 years
Sierra San Antonio Medical Plaza Fontana, CA
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[8]	$ 0
Initial Cost, Land	[8]	0
Initial Cost, Building & Improvements	[8]	11,538
Adjustments to Basis	[3],[8]	876
Land	[8]	0
Buildings and Improvements	[8]	12,414
CIP	[8]	336
Total	[8]	12,750
Accumulated Depreciation	[8]	$ 4,867
Date of Completion of Construction, Acquisition or Significant Improvement	[8]	2006
Date Acquired	[8]	2006
Average Depreciable Life	[8]	30 years
Vista Medical Terrace & Sparks MOB Sparks, NV
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[7]	$ 0
Initial Cost, Land	[7]	0
Initial Cost, Building & Improvements	[7]	9,276
Adjustments to Basis	[3],[7]	2,533
Land	[7]	0
Buildings and Improvements	[7]	11,809
CIP	[7]	123
Total	[7]	11,932
Accumulated Depreciation	[7]	$ 5,056
Date of Completion of Construction, Acquisition or Significant Improvement	[7]	2008
Date Acquired	[7]	2008
Average Depreciable Life	[7]	30 years
South Texas E R At Weslaco Weslaco T X
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		1,749
Initial Cost, Building & Improvements		4,879
Adjustments to Basis	[3]	0
Land		1,749
Buildings and Improvements		4,879
Total		6,628
Accumulated Depreciation		$ 1,468
Date of Completion of Construction, Acquisition or Significant Improvement		2015
Date Acquired		2015
Average Depreciable Life		35 years
Chandler Corporate Center III Chandler, AZ
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		2,328
Initial Cost, Building & Improvements		14,131
Adjustments to Basis	[3]	0
Land		2,328
Buildings and Improvements		14,131
Total		16,459
Accumulated Depreciation		$ 5,176
Date of Completion of Construction, Acquisition or Significant Improvement		2016
Date Acquired		2016
Average Depreciable Life		35 years
Frederick Crestwood Mob Frederick, MD
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		2,265
Initial Cost, Building & Improvements		18,731
Adjustments to Basis	[3]	0
Land		2,265
Buildings and Improvements		18,731
Total		20,996
Accumulated Depreciation		$ 5,281
Date of Completion of Construction, Acquisition or Significant Improvement		2016
Date Acquired		2016
Average Depreciable Life		35 years
Madison Professional Office Building Madison, AL
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		2,296
Initial Cost, Building & Improvements		6,411
Adjustments to Basis	[3]	133
Land		2,296
Buildings and Improvements		6,544
Total		8,840
Accumulated Depreciation		$ 1,987
Date of Completion of Construction, Acquisition or Significant Improvement		2016
Date Acquired		2016
Average Depreciable Life		35 years
2704 North Tenaya Way MOB Las Vegas, NV
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		3,032
Initial Cost, Building & Improvements		10,602
Adjustments to Basis	[3]	0
Land		3,032
Buildings and Improvements		10,602
Total		13,634
Accumulated Depreciation		$ 2,850
Date of Completion of Construction, Acquisition or Significant Improvement		2016
Date Acquired		2016
Average Depreciable Life		35 years
Hendserson Medical Plaza Henderson NV
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[7]	$ 0
Initial Cost, Land	[7]	0
Initial Cost, Building & Improvements	[7]	10,718
Adjustments to Basis	[3],[7]	10,500
Land	[7]	0
Buildings and Improvements	[7]	21,218
CIP	[7]	54
Total	[7]	21,272
Accumulated Depreciation	[7]	$ 8,538
Date of Completion of Construction, Acquisition or Significant Improvement	[7]	2017
Date Acquired	[7]	2017
Average Depreciable Life	[7]	35 years
Health Center at Hamburg Hamburg, PA
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		696
Initial Cost, Building & Improvements		3,406
Adjustments to Basis	[3]	0
Land		696
Buildings and Improvements		3,406
Total		4,102
Accumulated Depreciation		$ 886
Date of Completion of Construction, Acquisition or Significant Improvement		2017
Date Acquired		2017
Average Depreciable Life		35 years
Las Palmas Del Sol Emergency Center West El Paso, TX
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		801
Initial Cost, Building & Improvements		5,029
Adjustments to Basis	[3]	0
Land		801
Buildings and Improvements		5,029
Total		5,830
Accumulated Depreciation		$ 1,180
Date of Completion of Construction, Acquisition or Significant Improvement		2017
Date Acquired		2017
Average Depreciable Life		35 years
Beaumont Sleep Centrer Southfield, MI
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		254
Initial Cost, Building & Improvements		2,968
Adjustments to Basis	[3]	0
Land		254
Buildings and Improvements		2,968
Total		3,222
Accumulated Depreciation		$ 667
Date of Completion of Construction, Acquisition or Significant Improvement		2018
Date Acquired		2018
Average Depreciable Life		35 years
Clive Behavioral Health Clive IA
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		1,330
Initial Cost, Building & Improvements		0
Adjustments to Basis	[3]	33,954
Land		1,330
Buildings and Improvements		33,954
Total		35,284
Accumulated Depreciation		$ 4,258
Date of Completion of Construction, Acquisition or Significant Improvement		2020
Date Acquired		2019
Average Depreciable Life		35 years
Bellin Health Family Medicine Center Escanaba, MI
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		605
Initial Cost, Building & Improvements		3,906
Adjustments to Basis	[3]	0
Land		605
Buildings and Improvements		3,906
Total		4,511
Accumulated Depreciation		$ 651
Date of Completion of Construction, Acquisition or Significant Improvement		2019
Date Acquired		2019
Average Depreciable Life		35 years
Sand Point Medical Properties Escanaba, MI
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		265
Initial Cost, Building & Improvements		1,654
Adjustments to Basis	[3]	0
Land		265
Buildings and Improvements		1,654
Total		1,919
Accumulated Depreciation		$ 203
Date of Completion of Construction, Acquisition or Significant Improvement		2020
Date Acquired		2020
Average Depreciable Life		35 years
Fire Mesa, Llc Las Vegas, NV
Real Estate and Accumulated Depreciation [Line Items]
Initial Cost, Land		$ 2,400
Initial Cost, Building & Improvements		9,671
Land		2,400
Buildings and Improvements		9,671
Total		12,071
Accumulated Depreciation		$ 1,209
Date of Completion of Construction, Acquisition or Significant Improvement		2021
Date Acquired		2021
Average Depreciable Life		35 years
Texoma Medical Plaza Denison, TX
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[7],[9]	$ 0
Initial Cost, Land	[7],[9]	0
Initial Cost, Building & Improvements	[7],[9]	19,771
Adjustments to Basis	[3],[7],[9]	214
Land	[7],[9]	0
Buildings and Improvements	[7],[9]	19,985
Total	[7],[9]	19,985
Accumulated Depreciation	[7],[9]	$ 6,764
Date of Completion of Construction, Acquisition or Significant Improvement	[7],[9]	2021
Date Acquired	[7],[9]	2021
Average Depreciable Life	[7],[9]	39 years
Sierra Medical Plaza I Reno, NV
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1],[7],[10]	$ 0
Initial Cost, Land	[7],[10]	0
Initial Cost, Building & Improvements	[7],[10]	24,370
Adjustments to Basis	[3],[7],[10]	28
Land	[7],[10]	0
Buildings and Improvements	[7],[10]	24,398
CIP	[7],[10]	4,022
Total	[7],[10]	28,420
Accumulated Depreciation	[7],[10]	$ 771
Date of Completion of Construction, Acquisition or Significant Improvement	[7],[10]	2023
Date Acquired	[7],[10]	2021
Average Depreciable Life	[7],[10]	35 years
Beaumont Heart & Vascular Dearborn, MI
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Beaumont Heart & Vascular Center Dearborn, Mi
Real Estate and Accumulated Depreciation [Line Items]
Initial Cost, Land		537
Initial Cost, Building & Improvements		4,434
Land		537
Buildings and Improvements		4,434
Total		4,971
Accumulated Depreciation		$ 356
Date of Completion of Construction, Acquisition or Significant Improvement		2022
Date Acquired		2022
Average Depreciable Life		35 years
140 Thomas Johnson Drive Frederick, MD
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		1,197
Initial Cost, Building & Improvements		5,635
Land		1,197
Buildings and Improvements		5,635
Total		6,832
Accumulated Depreciation		$ 414
Date of Completion of Construction, Acquisition or Significant Improvement		2022
Date Acquired		2022
Average Depreciable Life		35 years
McAllen Doctor's Center McAllen, TX
Real Estate and Accumulated Depreciation [Line Items]
Encumbrance	[1]	$ 0
Initial Cost, Land		1,343
Initial Cost, Building & Improvements		4,440
Land		1,343
Buildings and Improvements		4,440
Total		5,783
Accumulated Depreciation		$ 98
Date of Completion of Construction, Acquisition or Significant Improvement		2023
Date Acquired		2023
Average Depreciable Life		35 years
[1] Consists of outstanding balances as of December 31, 2023 on third-party debt that is non-recourse to us. The aggregate cost for federal income tax purposes is $ 710 million (unaudited) with a net book value of $ 422 million (unaudited). Consists of costs subsequent to acquisition that were capitalized, divested or written down in connection with asset impairments and hurricane related damage. Carrying value of depreciable assets were written down to zero as a result of substantial damage from Hurricane Harvey during the third quarter of 2017. During 2008, a $ 4.6 million provision for asset impairment was recorded in connection with the real estate assets of Southern Crescent Center I & Southern Crescent Center II. Carrying value of depreciable assets were written down as a result of substantial damage from Hurricane Harvey during the third quarter of 2017. We are the lessee with a UHS-related party on a ground lease for land. We are the lessee with a third party on a ground lease for land. We purchased the 5 % minority interest held by a third party during the fourth quarter of 2021. As a result of the minority interest purchase, we own 100 % of the LP. New construction project related to a new MOB located in Reno, Nevada, which was substantially completed in March, 2023 and is located on the campus of a UHS wholly- owned hospital that was completed and opened in April, 2022.

Schedule III Real Estate and _2

Schedule III Real Estate and Accumulated Depreciation (Parenthetical) (Detail) - USD ($) $ in Millions	3 Months Ended	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2008	Dec. 31, 2023	Dec. 31, 2022
Real Estate and Accumulated Depreciation [Line Items]
Provision for asset impairment		$ 4.6
Aggregate cost of properties for federal income tax purposes			$ 710	$ 681
Net book value of the properties for federal income tax purposes			$ 422	$ 406
LP
Real Estate and Accumulated Depreciation [Line Items]
Purchase of minority ownership interest percentage	5%
Grayson Properties
Real Estate and Accumulated Depreciation [Line Items]
Ownership percentage upon completion of the minority ownership purchase	100%		100%

Reconciliation of Real Estate P

Reconciliation of Real Estate Properties and Accumulated Depreciation (Detail) - USD ($) $ in Thousands		12 Months Ended
		Dec. 31, 2023		Dec. 31, 2022	Dec. 31, 2021
SEC Schedule, 12-28, Real Estate Companies, Investment in Real Estate and Accumulated Depreciation Disclosure [Abstract]
Beginning balance		$ 697,969		$ 663,733	$ 660,449
Impact of consolidation of an LP	[1]				19,771
Additions	[2]	17,505		22,555	11,346
Acquisitions		5,783		11,802	12,071
Disposals/Divestitures	[3]	(15,013)		(121)	(39,904)
Ending balance		706,244	[4]	697,969	663,733
Beginning balance		248,772		225,584	216,648
Impact of consolidation of an LP	[1]				4,847
Disposals/Divestitures	[3]	(10,882)		(121)	(19,796)
Depreciation expense		24,559		23,309	23,885
Ending balance		$ 262,449		$ 248,772	$ 225,584
[1] During the fourth quarter of 2021, we purchased the 5 % minority ownership interest held by a third-party member in an LP in which we previously held a non-controlling majority ownership interest. As a result of this minority interest purchase, we now own 100 % of the LP and the financial results are included in our consolidated financial statements. Included in the additions for 2023, 2022 and 2021 are approximately $ 7.5 million, $ 18.0 million an d $ 2.9 million related to the construction of a new MOB , which was substantially completed in March, 2023, and is located on the campus of a UHS wholly-owned hospital that was completed and opened in April, 2022. The 2023 year includes the sale of the Corpus Christi facility, as well as the demolition of the building previously located on the now-vacant land in Chicago, Illinois. The 2021 year includes the sale of the Auburn Medical Office Building II, the sale of the Children’s Clinic at Springdale as well as the exchange of Inland Valley Campus of Southwest Healthcare System, located in Wildomar, CA. The aggregate cost for federal income tax purposes is $ 710 million (unaudited) with a net book value of $ 422 million (unaudited).

Reconciliation of Real Estate_2

Reconciliation of Real Estate Properties and Accumulated Depreciation (Parenthetical) (Detail) - USD ($) $ in Thousands		3 Months Ended	12 Months Ended
		Dec. 31, 2021	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Real Estate and Accumulated Depreciation [Line Items]
Additions	[1]		$ 17,505	$ 22,555	$ 11,346
LP
Real Estate and Accumulated Depreciation [Line Items]
Purchase of minority ownership interest percentage		5%
Grayson Properties
Real Estate and Accumulated Depreciation [Line Items]
Ownership percentage upon completion of the minority ownership purchase		100%	100%		100%
New Medical Office Building
Real Estate and Accumulated Depreciation [Line Items]
Additions			$ 7,500	$ 18,000	$ 2,900
[1] Included in the additions for 2023, 2022 and 2021 are approximately $ 7.5 million, $ 18.0 million an d $ 2.9 million related to the construction of a new MOB , which was substantially completed in March, 2023, and is located on the campus of a UHS wholly-owned hospital that was completed and opened in April, 2022. The